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3D Echocardiogram/MVP/MVR
I am a 42 year old healthy woman with no medical problems other than MVP and MVR. I have been monitored since 12 years old and until the last 5-10 years, I really have never had may issues with it. I was always told it was mild regurg. Now I have shortness of breath and PACs (premature atrial contractions) with normal sinus tach as found on halter monitor. Up until yesterday I was told that I have mod/severe regurgitation with posterior leaflet prolapse and myxomatous disease. Since it was my normal 1 year appt, I had requested last month for my dr. to set me up with a 3d echo because I have researched this so much and realized how useful the test is to see the valve in amazing detail and accuracy with regurg. After yesterdays 3d echo, the tech told me that I definitely have Severe regurgitation with anterior and posterior prolapse and both are myxamatous. I also have pulmonary arterial meausurement of 30 mm Hg. There is also a small pericardial effusion, which she pointed out to me. I have an inter-atrial septal aneurysm with no shunting. My last EF in 2009 was 55% and I'm not sure what yesterday's was. I obviously do not have the official report but my gut feeling is that my cardiologist is going to say its time for repair and I'm really scared and wondering about the timing of surgery and recommendations from the AHA. Oh I forgot to mention that my left atrial measurement has ranged from 3.7 to 4.2 during the last couple years and from machine to machine. I do not know what it was yesterday.
What is your opinion of this and your knowledge of the accuracy of 3d etc. I really appreciate your assistance and whatever you can provide to me for info.
Kind regards.
What is your opinion of this and your knowledge of the accuracy of 3d etc. I really appreciate your assistance and whatever you can provide to me for info.
Kind regards.
Yes, I did see my heart functioning in 3D and it was the most sureal experience thinking that that unbelievable image on the screen is what has maintained my every breath since the day I was born. There really is no comparison to the 2D in terms of imaging and really seeing what the valve looks like. You should definitely have this done if you are able to find a facility and also if your insurance covers it. Mine covered it 100% and I think it has been the most valuable diagnostic tool that has ever been used since I was diagnosed from a child. Just to make sure I explained it right --- the 3D was transthoracic, not TEE. I am sitting on pins and needles waiting for my cardiologist to call with the results. Of course the tech was wonderful and told me everything as she did the echo, but of course she said that it was going to take a "team of about 4 people" to make the final report and study each and every picture to get measurements, etc.....
Thanks for the information. It appears 3D reconstruction to 2D screen has software application that enable visualizing in 3D and is the very best procedure to analysis the mitral valve functionality... You saw your heart functioning in 3D?
March 10, 2010, AmericanHeart.org: Basically, it can give a surgical view, he adds, providing surgeons planning to repair a valve with images very similar to what they will see at the time of surgery. It can also accurately measure the size of the orifice of certain valves, particularly the mitral valve, he added. In mitral valve stenosis, it has now been shown that real-time 3D echo is more accurate than other noninvasive modalities in measuring the mitral valve area, he said.
As surgical and nonsurgical methods for repairing valves become more advanced, Gillam says, it becomes more critical to be able to define exactly what's wrong with the valve. "Again, I think we've done a reasonably good job with two-dimensional echo methods but, in effect, when you use two-dimensional methods it's the brain of the person looking at the echo images that translates that image into a three-dimensional construct of how the valve looks, how it's structured, and how it's working," she points out. "With three-dimensional echocardiography, people who aren't echocardiographers can appreciate valve anatomy and physiology in three dimensions. Surgeons tend to very much appreciate three-dimensional images because the echo image looks exactly like what they see when the heart is open."
March 10, 2010, AmericanHeart.org: Basically, it can give a surgical view, he adds, providing surgeons planning to repair a valve with images very similar to what they will see at the time of surgery. It can also accurately measure the size of the orifice of certain valves, particularly the mitral valve, he added. In mitral valve stenosis, it has now been shown that real-time 3D echo is more accurate than other noninvasive modalities in measuring the mitral valve area, he said.
As surgical and nonsurgical methods for repairing valves become more advanced, Gillam says, it becomes more critical to be able to define exactly what's wrong with the valve. "Again, I think we've done a reasonably good job with two-dimensional echo methods but, in effect, when you use two-dimensional methods it's the brain of the person looking at the echo images that translates that image into a three-dimensional construct of how the valve looks, how it's structured, and how it's working," she points out. "With three-dimensional echocardiography, people who aren't echocardiographers can appreciate valve anatomy and physiology in three dimensions. Surgeons tend to very much appreciate three-dimensional images because the echo image looks exactly like what they see when the heart is open."
The procedure that I had done was a 3 dimensional echocardiogram. It was absolutely amazing and was like I was looking at my own heart right in front of me. I actually saw my mitral valve and it really gave me a different perspective all together on this whole mitral valve prolapse/regurgitation problem. You should google 3 Dimensional echocardiogram of the mitral valve and then click on images.
I am so glad that I was as proactive as I was in pushing my doctor to find me a facility near where I live to have this done. It definitely shed different information as compared with the many many 2D that were done on me in the past 20 years. I did have a TEE about 2-3 years ago and it totally contradicted all of the regular 2D echos done prior the TEE. Instead of diagnosing me with moderate/severe, the TEE actually said I had mild (WHICH WAS TOTALLY WRONG).
My cardiologist that I have now actually said that the medications that they use to sedate you during a TEE slow down the hemodynamics of your heart function and changes the way the blood flows through the valve. He was correct because yesterdays 3 dimensional showed severe --- not moderate/severe. They even moved me to a different machine to compare and they both said "severe". It is supposed to be the new gold standard for correctly diagnosing mitral valve disease.
Has anyone else out there ever had a 3d done?
I am so glad that I was as proactive as I was in pushing my doctor to find me a facility near where I live to have this done. It definitely shed different information as compared with the many many 2D that were done on me in the past 20 years. I did have a TEE about 2-3 years ago and it totally contradicted all of the regular 2D echos done prior the TEE. Instead of diagnosing me with moderate/severe, the TEE actually said I had mild (WHICH WAS TOTALLY WRONG).
My cardiologist that I have now actually said that the medications that they use to sedate you during a TEE slow down the hemodynamics of your heart function and changes the way the blood flows through the valve. He was correct because yesterdays 3 dimensional showed severe --- not moderate/severe. They even moved me to a different machine to compare and they both said "severe". It is supposed to be the new gold standard for correctly diagnosing mitral valve disease.
Has anyone else out there ever had a 3d done?
Pulmonary systole pressure is normal at 25 mmHg, and not considered a problem unrtil the mean is 35mmHG.
I have had aschemic moderate to severe MVR for the past 6 years with no symptoms, so the doctor has been closely monitoring and feels a repair/replacment is warranted until there are symptoms. My research indicates not to wait until there are symptoms but to have the procedure before there chamberf enlargement and reduced EF.
I don't believe I have MVP, but apparently my MVR is related to a 6 year ago enlarged left ventricle that either deformed the valve opening and/or the chordae and papilary muscle.
Just yesterday information was mitral valve prolapse with severe regurgitation reduces long-term survival irrespective of medical therapy. It appears that the prolapse itself is not the cause of mortality or morbidity (cardiac event rates are extremely low for the entire population with prolapse), but it is severe regurgitation and consequent left ventricular dilatation that results in morbidity. Regardless of the underlying cause it is the ventricle dilation that is the issue and puts one at a higher risk..
Enriquez-Sarano a renown heart surgeon with thousands of valve operations has stated the biggest problem he sees is that the patient waited too long for the operation. If I am lucky all I will need is reforming the orifice with a ring and can be done with a cath
Before there is any intervention, it is my understanding a TEE is done for the best view of the valve...was that the procedure you had?
I have had aschemic moderate to severe MVR for the past 6 years with no symptoms, so the doctor has been closely monitoring and feels a repair/replacment is warranted until there are symptoms. My research indicates not to wait until there are symptoms but to have the procedure before there chamberf enlargement and reduced EF.
I don't believe I have MVP, but apparently my MVR is related to a 6 year ago enlarged left ventricle that either deformed the valve opening and/or the chordae and papilary muscle.
Just yesterday information was mitral valve prolapse with severe regurgitation reduces long-term survival irrespective of medical therapy. It appears that the prolapse itself is not the cause of mortality or morbidity (cardiac event rates are extremely low for the entire population with prolapse), but it is severe regurgitation and consequent left ventricular dilatation that results in morbidity. Regardless of the underlying cause it is the ventricle dilation that is the issue and puts one at a higher risk..
Enriquez-Sarano a renown heart surgeon with thousands of valve operations has stated the biggest problem he sees is that the patient waited too long for the operation. If I am lucky all I will need is reforming the orifice with a ring and can be done with a cath
Before there is any intervention, it is my understanding a TEE is done for the best view of the valve...was that the procedure you had?
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