Comments on: “Did You Get An M.R.I. Before Heart Valve Surgery?” Asks Gregg

By: MJ Samer

MJ Samer — Tue, 25 Aug 2009 16:04:09 +0000

I had a cardiac MRI last week at Northwestern Memorial Hospital in Chicago which my cardiologist told me gave them much clearer data than just an echocardiogram. I will need pulmonary valve replacement and probably tricuspid valve replacement, too in the next couple of months. They want to do one more diagnostic test: a cardiac catheterization.
MJSamer

By: Chaz

Chaz — Tue, 25 Aug 2009 01:33:09 +0000

My surgeon had a CT scan done prior to by aortic valve replacement. He was concerned that the leakage/tear might be larger than indicated by the echocardiagrm and he wanted to prepare for other surgical “possibilities” with more exact measurments. I do know that he used the CD of the CT scan during the operation

By: nerida

nerida — Tue, 25 Aug 2009 00:21:07 +0000

Gregg,
I am 39, had no symptoms at all, I am a mother of 3 and work 4 days a week in childcare. (i am very busy). My heart issue was picked by an aneathetist prior to a having my tubes tied. “You have a heart murmur, it’s very loud.” he told me. I had made it through 3 pregnancies and life in general without this being picked up. I had my little op and booked in to see the cardiologist in late april, at which point i discovered i had a bicuspid aortic valve with severe stenosis. I had an angiogram and a TOE ultrasound(swallowed a camera). It was then decided I should have an MRI as it appeared my aorta was slightly swollen, this would give the surgeon a clearer picture as to whether my aorta needed attention as well. I am now 4 weeks post op (mechanical valve) as it turned out my aorta was OK. I feel fantastic. I am walking every day and cant wait to drive and get back to life in general. Having as many tests and pictures can only give your doctors a clearer picture of what is going on.
Good luck
Nerida

By: Gail

Gail — Mon, 24 Aug 2009 23:32:03 +0000

My husband had an MRI done pre-op. Initially it was not part of the plan. The cardiologist following him was away on vacation and the doctor we saw thought the valve didn’t look so bad. They decided that the decision would be made to continue with surgery dependent on the MRI results. The MRI showed it needed to be done

By: Rhena Smith

Rhena Smith — Mon, 24 Aug 2009 18:59:09 +0000

I just had a heart catheterization on the 7th of August, and in my follow-up with my cardiologist, I asked about an MRI if that could tell more about the situation – particularly I was trying to find out if my aortic valve was bi-cuspid as they were still not sure. I was concerned about other connective tissue disorders that seem to often accompany bi-cuspid AV. Anyway, long story short – they do not routinely doe MRI’s for heart Vavle. They said the gold standard was a hearth cath – which is of course a more invasive procedure than an MRI.

By: LaVonne Neff

LaVonne Neff — Mon, 24 Aug 2009 18:38:15 +0000

About the MRI (or MRA: magnetic resonance angiogram): I’m wondering if that would be for the enlarged aorta (aka aneurysm) rather than for the valve problem. I believe CT or MRA scans are more accurate than echocardiograms in calculating the aorta’s diameter.

By: Adam Pick

Adam Pick — Mon, 24 Aug 2009 03:45:45 +0000

Lisa,

Like you, I did not require an angiogram prior to surgery given my age and active lifestyle.

However, it was very interesting… My first cardiologist, Dr. Bad Bedside Manner, put me on the super, super, super fast track for an angiogram two days later. After reading books, like Coronary, that was another signal (for me at least) that I should consider other cardiologists quickly.

I’m glad I did not stick with that Dr. Bad Bedside Manner. I later learned he did the exact same thing to another patient.

Thanks for bringing this point up! If any of you are interested in learning more about angiograms / cardiac catheterizations, here is a great patient story:

http://www.heart-valve-surgery.com/heart-surgery-blog/2008/08/18/cardiac-catheterization-procedure-insurance-fear-pain-going-home/

Keep on tickin!

Adam

By: Lisa

Lisa — Mon, 24 Aug 2009 02:01:46 +0000

I had a standard echocardiogram, a transesophogeal echo, and a specialized cardiac CT scan. With the CT scan there was enough info that I did not have to have an angiogram prior to mitral valve repair surgery. However, I am young and very active so the docs were not worried about any coronary artery disease. As mentioned previously, I had to have I.V. metoprolol as well as sublingual nitroglycerine administered to maximize the images.

By: jerry

jerry — Mon, 24 Aug 2009 00:51:33 +0000

It was about 25 years between first diagnosis in college and surgery, and while the first were b&w echos, the latter diagnoses were via color doppler echos with a twist of lemon and an MRI.

I can’t say which the cardiologist found most useful, the MRI required I take some metoprolol in order to get my heart rate down to the 60bpm that was the upper limit of the MRI.

All of it was covered by insurance — I don’t know the actual costs involved.

In the end, my cardiologist seems to really favor an angiogram as the ultimate diagnostic tool.