I am male, 60 yrs old and overweight, 16,11. In 2023 i was diagnosed with severe aortic stenosis. My cardiologist told me the aortic valve needs replacing and was sending me for a TAVI, months went by and various test were done and it was decided that i was unsuitable for TAVI as vascular access was not possible on some arteries and only borderline on 1. it was decided on the MDT that i should have a surgical valve replacement and sent my case to a surgeon. Went to see a surgeon this year 2024, the surgeon said to me, there is no point in me doing this operation as your not going to be running any marathons and that i only had moderate stenosis with 1.cm valve, he said if i lost 3 stone i could probably put the operation off for 5 or 10 years. He sent me for further test and i went to see him again, told me he was pleased with the progress i had made with losing weight and eating a health diet and then said he would take me on for the operation, i told him that i could manage ok and did not want the operation unless i had to have it, but did not want to turn it down and end up dying because i didn't have it. He said he was sending me for another echocardiogram and would send my case to the MDT. I had the echo test 3 weeks later and consultant said your aortic valve is 0.6 to 0.7 mm, i have severe aortic stenosis and it was not a bad thing i had waited 12 months for the operation as i had lost weight and be fitter for it. All this is leaving me very confused, i am getting conflicting views from the surgeon and everyone else at the hospital, 3 or 4 times when I've gone for tests the nurses have commented that it wont be long now before they do the operation and these tests are in preparation for the operation etc etc, and this was all different people on different days and departments. Now i find out they are sending me for another echo. Can anyone tell me how far my valve has to close before the need to operate. Apart from heart palpitations and some rhythm, tightness in chest, angina, sleepless nights, i can walk 2 or 300 yards and my ankles are not swollen. I try to keep away from anything that will put strain on my heart. Any advise would be great. Thanks
SEVERE AORTIC STENOSIS: I am male, 6... - British Heart Fou...
SEVERE AORTIC STENOSIS
You are still relatively young. How much heavier are you than your "ideal" weight" for your height?
Walking 200 or 300 yards does not sound very much. Do you have any other mobility problems or is this your limit because you then start to have these heart issues?
Hi i am 5,8 and always been over 12 stone from being a teenager, i struggle with my weight. i have type 2 diabetes, COPD, Sleep Apnoea. Had a double bypass in 2015, have angina, mild.
Around 12 stone would seem to be ideal. I am a similar height to you and have always been around a stone heavier than ideal. If you are still substantially overweight it might be useful to lose more as that will affect all aspects of your health.
Its difficult for a non medical person to advise but without mobility problems I would expect to walk further than a few hundred steps without problems -especially at your age.
I should be down to 14st soon and then next target, 13st. i will be happy around that. It just plays on your mind when one consultant says you need your aortic valve changing and another says you can put it off for 5 or 10 yrs. i will know soon what's happening.
Good luck on reaching your next target which in itself might help your walking.
Has your consultant told you what you might expect as regards your future fitness levels and ability to walk, exercise and live a normal life?
Hopefully all will become clearer after another echo.
No one has told me anything. Last time i spoke to my consultant it was to tell me i need the aortic valve changing and they were going to do it by TAVI. then months later i find out they cant do it as access via TAVI was unsuitable, so then sent my case to surgeon my last echo the consultant that then said my valve was 0.6-0.7mm and for me not to worry as the 12 months waiting for the operation was not a bad thing as ive lost weight and would be healthier for it. This is why i am all confused. Have a read through my first post again and it explains things better.
I know it's difficult, when you are getting mixed messages, but try not to worry too much. I belong to a Facebook group for people who are waiting for aortic value replacement or have had it. All the people who have had the operation are doing absolutely fine. I can send you the link to the group of you like .
It is difficult to be honest, its the not knowing if i am having it or not. Like you say the mixed messages, they play games in your mind and you start to doubt people and wonder what the hell is going on. Look at it this way, there is a chance i will get told at the end of December i don't need this operation for a few years, but if the TAVI team would have found me suitable for the operation ( which they did not due poor vascular access ) I would have had a replacement valve done by now when i didn't really need it. Its tricky isn't it. Thanks for the kind offer to send me the link for Facebook group, but ive never done Facebook and wouldn't know my way round it.
There are a lot of factors that go into the decision, including valve cross-section, EF, symptoms, valve pressure-gradient, and surgery risk. (And, in my case, the "already in there" factor as they had to repair my mitral valve anyway.)
Is the echo that they're sending you for a transesophageal echo (TEE)? Your previous echos were probably transthoracic (TTE). A TEE (being more expensive/invasive) is a pretty good sign that they want to get a better look at things in prep for surgery.
At some point they'll probably also do a carotid artery echo to see if they need to make any adjustments to the bypass machine pressure. (I had that done in hospital the night before the operation.)
Hi I found out today that the appointment for the transoesophageal echo was a mistake and they don't need to do one again. They have already done 2, one in around July last year and 1 in October this year. these are scans from outside the chest. The consultant who was doing this latest 1 told me at the start, we might not have to put the camera down my throat as they got a good enough image last time. Whilst they were doing it, they were talking amongst themselves saying, i don't know why they have sent him for another one of these, its just academic, we can see what he has got by looking at the images. Ive also had CT Scan, Cartoid Doppler scan of neck, , Cardio Angiogram, etc.
Well that’s good anyway.
I can sympathise with the stress of not knowing. I remember laying in the hospital bed the night before and my biggest fear was not the operation, but that they’d come in and say they couldn’t do it for some reason or another and I could get dressed and go home.
Yes and there is a big difference between having it and not having it, you need to be prepared for it, also with conflicting views, you start to doubt people, is he right, are they wrong, is he wrong etc. That's more on my mind really than having the operation.
I’m in a similar position including similar weight loss. See my post some about Easy-AS programme you might want to look into. Not guaranteed you can get on it. I go to the gym and do weights, treadmill and cross trainer two or three times a week. Consultant agrees this is a big positive. I think that generally they will only do operation if you are critical. The Easy-AS project has been set up to compare early action with asymptomatic patients against those who have later intervention.
Ok thanks for that i will look into it. would you mind telling me what your valve size is down to and how often do you go for checks.
Sorry, I have no idea of my valve size. I’ll check my information and see if there’s anything there. I’ve been going for checks every six months for about 3 years and am told I’m at the bottom end of “severe”.
Ok no problem just curious that's all.
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