Heart Valve replace or NOT -conflict

[Vince27]

I have been diagnosed with bicuspid aortic valve with regurgitation (leak) leading to enlarged left ventricle and dilated aortic root. My cardiologist #1, put me through various tests. Stress test conclusions, clinically negative for myocardial ischemia. ECG negative for myocardial ischemia, normal homodynamic response to Treadmill Exercise stress. and Exercise capacity was good, Test negative for ischemia by ekg.  The echocardiography test showed the regurgitation in cardiologist #1 term “significant” My second opinion the regurgitation in cardiologist #2 termed “Moderate”.  The third test a catheterization on my right and left sides showed no signs of heart disease and this test shows the regurgitation in cardiologist #1 term as “Moderate”. Heart measurements –
Heart – 6.5 cm, Aortic root 4.5 cm… No bench mark exists.
Here is my conflict, the treatments:
Cardiologist #1 – Stop all current exercise routines and schedule surgery – replace valve within the next few weeks do not go much longer then 2 month.
Cardiologist #2 – Confirmed that surgery will have to happen in my life time but - Continue with your aerobic type exercise, stop any weight lifting type workouts. Repeat echocardiography test every six months to look for change mad consider rate of change.
What path to take….. ? my personal history, until I stopped my exercise routines consist of 3 to 6 mile walks -2 or 3 times weekly, I play 1.5 to 3 hours Ice Hockey weekly, I have minor chest discomfort from time to time, but nothing I ever felt was an issue. The fact is that I would not know of the regurgitation (leak) if my EKG did not show reason to check further.  49 yrs 230 lbs, 5ft 10.5 in (30% body fat). Vitals all normal.  

[purple66]

I think cardio #1 seems to be more on the mark withtreatment for what you have described. I was boren with a bicuspic aortic valve and had open heart surgery back in 1979 then this past year my valve function had deteriorated to what they called "severe aortic stenosis" and "critical aortic insufficiency" as well as an aortic aneurism.

I was working 60+ hours/week prior but immediately had to quit and was told not to do anything that made me out of breath until surgery which I had 6 weeks later. When they got in there my aortic root was less than 4 cm so it was not replaced but I recieved a new valve.

The bicuspid valve makes for problems with exercise and is, in fact, the cause of the dilated root. I would lean towards cardio #1

Best of luck,

Jeanne

[kenkeith]

QUOTE: "Heart – 6.5 cm, Aortic root 4.5 cm… No bench mark exists.
Here is my conflict, the treatments":

Left ventricle diastolic (filling capacity) size is 3.5-5.7 cm.  The 6.5 cm indicates an enlarged left ventricle.

Aortic root 4.5 cm (normal range 2.0-3.7 cm).  Generally when the size is greater than 4.0 cm, the condition is medically referred to as an aneursym.  generally when and if the size increases to 5.0 cm or greater there is a danger for a rupture.  

If the LV is enlarged, surgery may be risky!  QUOTE: "Cardiologist #2 – Confirmed that surgery will have to happen in my life time but - Continue with your aerobic type exercise, stop any weight lifting type workouts. Repeat echocardiography test every six months to look for change mad consider rate of change".

My cardiologist is watching and testing for the past 6 years for a mitral valve regurgitation condition (moderate to severe), and I lift weights and aorobic exercise routine.   But the aorta involves a different protocol. There is no proven link between exercise and harmful outcome from an enlarged aorta.  Nonetheless, many physicians feel that such patients shouldn’t engage in strenuous exercise, particularly activity that involves straining weight lifting. No limitations for aorobic exercise.