Friday, December 17, 2010

And the winner is ... a heart valve replacement operation

Now that the house renovation was finished, I was contemplating what my next adventure should be - arranging a reunion for graduates of Edgarton Memorial School between 1957 and 1967 or getting into the historical society to do some organization of the material - but the choice was made for me.  I need to get my stenotic bicuspid aortic valve replaced.  That means open heart surgery with me on a heart-lung machine getting a plastic valve put in the place of my faulty one.  I will need warfarin (yep, rat poison) for the rest of my life to prevent dangerous clots and plaque buildup around the plastic valve.  This is not a fun adventure but a necessary one.

So, what the heck is a stenotic bicuspid aortic valve you say and why is it important?  The aortic valve lets the oxygenated blood out of your heart into the blood vessels so that your cells can convert sugars in your blood and cells into energy for your muscles and brain.  Pretty important, I'd say.  A normal heart valve is tricuspid (has 3 flaps) but mine is bicuspid (has 2 flaps).  That is significant because it cuts down on the amount of blood that can flow out of my heart in one pump.

To explain, take a round plastic lid from a margarine container and cut it down the middle with one single slash, then squeeze the edges of the lid towards each other and examine the opening, seeing two "flaps". Now, take another lid and this time make a Y shaped cut instead of a single line.  When you squeeze the edges of the lid together, you see three flaps and the hole will let more liquid through more easily.  As a child I had less stamina and lower peak performance of my contemporaries, and this is why.  Regardless of how much harder I worked to get faster or last longer or be more efficient in movement, my heart valve was rate limiting (techno speak - that's me) and I could not overcome that.

Stenosis means stiffening.  So, now do I not only have a defective valve but it doesn't even work as well as when I was younger.  It doesn't open as far as it used to.  Hence, I huff and puff going fast or climbing stairs.  This usually is accompanied by heart pain, but I have either come to ignore it or I just don't experience it.  The doctor is not certain.  I do know that I can feel heart pain if I shovel snow as I did last winter, and so I don't do that anymore.

When someone has this condition, the doctor looks at pain level, how much blood is flowing, the size of the heart chamber, and the size of the valve opening to determine when the valve should be replaced.  This year's echo cardiogram showed the blood flow is up (thanks to Pilates) but the chamber is showing enlargement (for the Grinch, heart enlargement is a very good thing; for a human, it is not), and the valve opening is very severely restricted to 0.5 centimeters.  Anything under 1 centimeter is considered severe.

So, it's time to do this before it becomes an emergency situation involving an ambulance and a helicopter.  I will be meeting with the liaison between my cardiologist and the University of Pennsylvania hospital later in January to plan out the tests and surgery.  They may stick a teensy camera in a vein and run it through to my heart to see the valve in operation and check for other problems.  That would be an adventure indeed.


NWDonna said...

Well I'm stunned! And my thoughts and prayers are with you.

lena89 said...

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