Aortic Stenosis

[tarren]

I am 70yrs old and have a bicuspid aortic valve that has become more calcified over time. The pressure gradient has increased to 57 and the condition has changed from moderate stenosis to severe stenosis. At this point I have no symptoms and exercise regularly.

My question is, at what point will surgery be necessary? My doctor says that I should wait until I have symptoms. Shortness of breath, passing out, etc. Logically it would seem to me that at that point I am showing signs of heart failure and my heart will have already become damaged. It seems to me that it is like waiting for someone to have a heart attack before performing heart bipass with someone who has severely clogged arteries.

My doctor explains that aortic valve surgery is highly risky and breakaway calcium deposits can cause a stroke So that is the reason for going slow before turning to surgery. From my perspective, I would rather undergo risky surgery then find my self with advance heart failure and have to change my present lifestyle.

Are there any others who have had this surgery and can speak to this risk? Also is my doctors advise pretty standard for this condition.

[Ol racer]

Hello,
I am 67 in very good health & very active physically working 10+hrs a day when recently during routine exam family doc suprisingly heard a murmur leading me for further testing by Cardilogist and Surgeons advising just the opposite recommending immediate surgury for my severe AS despite NO symptoms whatsoever. I feel the opposite of your desire and delay until (at least) one symptom would appear making the risk associated with the required major surgury tangible. I am researching further but its just a thought.....

[sandpiper]

Hello - I have joined this site hoping to gain an insight into the likely risks and aftercare that will be required when my partner has his valve replacement operation on Thursday 24 Jan. He is 59 years old, and has only mild symptons, but has been advised by his cardiologist that the op needs to be done now. Any advice/experiences would be much appreciated. He has opted for a tissue replacement valve, by the way.

[Ol racer]

Hello - I have joined this site hoping to gain an insight into the likely risks and aftercare that will be required when my partner has his valve replacement operation on Thursday 24 Jan. He is 59 years old, and has only mild symptons, but has been advised by his cardiologist that the op needs to be done now. Any advice/experiences would be much appreciated. He has opted for a tissue replacement valve, by the way.

[Ol racer]

Hello Sandpiper,
I have been recently diagnosed with AS suprisingly, and I have had two Surgeons opinions to operate however I have no symptoms whatsoever (yet). As a result I have researched AS thoroughly and read 50% of Doctors recomend surgury right away while the other 50% say to wait for a symptom. However they all agree 100% that once a symptom appears surgury should be performed immediately to prevent further heart damage.

Additionally I read a Tissue Valve is the best choice for an active Person because of not requiring long term blood thinners. However the Tissue valve eventually wears out in 10 - 15 yrs and will need re-replacement. The Mechanical Valve never wears out but requires long term blood thinners....

A few very large Hospitals are experimenting with 'less invasive' Valve Replacement procedure under microscope but only certain cases would qualify.I was told to be successful opening the chest is best method.

My Surgeons said recovery depending on the Person typically 5 - 7 days in the hospital and about a month of in activity then your pretty much back to normal. The most discomfort is actually from the rib cage mending ... Good Luck to you both and let me know how it goes...

[tarren]

I have now had a second echocardiogram and my cardiologist said that I can wait another six months for surgery or get it done now. He indicated that with the progression of the stenosis, within six months I will begin having systems. I have decided to go ahead with the surgery as it is just a case of doing it now and take the risks of surgery or do it later with symptoms and find that damage was done. I will need to talk with my surgeon re: tissue versus metal valve. There is very little history with the human cadaver valve but the porcine valve will last about ten years from what I have read. In ten years I will be eighty and not a very good candidate for open heart surgery so should I use metal now with the problem of blood thinners or take a chance with the human valve? Difficult question which I will have to address in three weeks.

[sandpiper]

Hello both of you posters.
Well the surgery went OK - no surprises.
He is now home but finding a lot of pain associated with coughing reflex etc. No doubt this will ease with time.
I would suggest that a good support network is set up for post-op care and assistance before any surgery is embarked upon. The after-care regime can be rigorous..
Good luck to you both.

SP

[Maras1]

I was told the same things by my MD and 1st cardiologist even though I felt I was starting to feel vary minor symptoms. My first thoughts were the same as yours are. I didn't want to have a heart attack and suffer damage while waiting to start passing out. I changed cardiologists. A second opinion was the best thing I ever did. I just had a catheter done and was told to go see a cardiothorasic surgion to schedule a valve replacement. I firmly believe you should trust and listen to your doctor, but if that little voice inside of you is having doubts, see another doctor. Better safe than sorry.