Rosemary Creutz - Heart Valve Journal

My Journal

2670 days ago

I am getting differing opinions as to the timing of my surgery. I was considering changing doctors and was in the middle of this when it was time to have my ...Read more

I am getting differing opinions as to the timing of my surgery. I was considering changing doctors and was in the middle of this when it was time to have my six month echo and CT. The echo and CT Scan measured my ascending aortic aneurysm at 4.9 (it grew .2 cm in 6 mo.) and my bicuspid aortic valve with mild stenosis and moderate regurgitation. The valve has been stable for ten years. I have a surgeon that indicated in the next six months it was time to take care of the aneurysm but said that he could not give me a better valve than the one I currently have. Another cardiologist at the new medical provider said that they wait until the aneurysm measures 5.5 cm when people are asymptomatic and the valve would be replaced at the same time. I am concerned because if it was only the valve we were dealing with I would still be waiting. Why would they remove a valve that is still functioning? Has anyone had this or similar situation? I have been following everyones journey and have found many posts to be insightful and thought provoking. Thanks!

Marie Myers I had a very similar situation. My bicuspid AV was functioning , but my aneurysm was 4.8 cm. Due to m ... Read more

Marie Myers I had a very similar situation. My bicuspid AV was functioning , but my aneurysm was 4.8 cm. Due to my petite size, I was encouraged to get it done. (Apparently, there is a formula to determine how your aneurysm relates to your body size.) At that time, there seemed to be no question in my surgeons mind that the valve would be replaced at that same time. This was fine with me. So, last March I got the aortic root. valve, and ascending aorta replaced. I am 63 and went with a tissue valve. I know many surgeons say wait till 5-5.5 cm, but you must factor in body size. Hope that helps...

Catie B Marie is exactly right. I'm posting a couple of links below that may help you. As to your aortic va ... Read more

Catie B Marie is exactly right. I'm posting a couple of links below that may help you. As to your aortic valve, I was given to understand that if your valve could be expected to need replacing within five years, they would go ahead and replace it during the aorta surgery. So it does depend on the condition of your valve. Also, I found surgeons to be far, far more knowledgeable about aortic aneurysms than cardiologists. Seeing another surgeon who performs many aortic surgeries may help solidify things for you. In this instance, it can really help to find the best-qualified, most experienced doctor possible.

http://www.valleyheartandvascular.com/Thoracic-Aneurysm-Program/Calculate-Your-Relative-Aortic-Size.aspx

http://www.valleyheartandvascular.com/Thoracic-Aneurysm-Program/Risk-Stratification.aspx

Valley Heart & Vascular Institute - Calculate Your Relative Aortic Size

http://www.valleyheartandvascular.com/Thoracic-Aneurysm-Program/Calculate-Your-Relative-Aortic-Size.aspx

We built our Heart and Vascular Institute on the expertise of more than 60 board-certified cardiologists and surgeons. Use our directory to find a doctor affiliated with the Heart and Vascular Institute. If you would prefer to speak with us, please call 201-447-8456.

Sandy Laine My situation very similar to all above. The first surgeon I saw said that he would only replace the ... Read more

Sandy Laine My situation very similar to all above. The first surgeon I saw said that he would only replace the valve if needed (but asked me what I wanted), the second one said that the current valve would not last as long as a replacement, so they would go ahead and replace while fixing the aneurysm. I did question it again (if it's not broken - why fix - but stenosis is considered broken (even when asymptomatic and not severe, apparently)). They stressed again that it would not last as long as even a tissue replacement valve (additional web searches seemed to support that), so...

Jill Krajnovich Hi Rosemary, I also had a very similar situation. I was diagnosed with a BAV as a child and had only ... Read more

Jill Krajnovich Hi Rosemary, I also had a very similar situation. I was diagnosed with a BAV as a child and had only begun regularly following up with a cardiologist at the end of 2013 after experiencing some episodes of irregular and rapid heartbeat. At that time, I was diagnosed with Wolff-Parkinson-White syndrome and underwent an ablation to remove an extra-accessory path in my heart. In the summer of 2016, I was diagnosed with an aortic aneurysm measuring 4.9 cm. The first surgeon I saw wanted to repair the aneurysm but not replace my valve as like yours, my valve showed only mild stenosis and moderate regurgitation. I sought a 2nd opinion and the surgeon wanted to repair my aneurysm and replace the valve as he felt it would be better to do in 1 surgery and I would eventually need it done. Both said I was borderline for needing the aneurysm repair as the guidelines are 5.5 cm but when you have any underlying heart condition, it is only 5 cm. Also being a smaller woman, I would be a candidate for surgery. As Marie said, they go by height and weight as well as the size of the aneurysm. I then sent my records to the Cleveland Clinic. I had testing there in May which showed the aneurysm and valve essentially unchanged. The surgeon there recommended I have surgery for both the aneurysm and the valve. He said he would try to repair the valve but if he could not, he would replace it with a bovine tissue valve. Following surgery, I was informed that my aneurysm measured 5.2 cm and my valve was unicuspid with severe calcification therefore, it could not be repaired and had to be replaced. I have learned that they can only see so much with non-invasive testing as both my aneurysm and my valve were worse than what the testing showed. The surgeon informed my husband that this surgery was definitely needed as my condition was much worse than originally thought.

Rosemary Creutz Thank you ladies for sharing your experience and knowledge! I really appreciate your input as I wres ... Read more

Rosemary Creutz Thank you ladies for sharing your experience and knowledge! I really appreciate your input as I wrestle with this decision. Your experiences have given me more things to consider. Thank you again