Heart Valve Summit Video #1: “When Can I Expect To Have Bicuspid Aortic Valve Surgery?” Asks Kim
By Adam Pick on October 19, 2012
Prior to the Heart Valve Summit, I received over 70 patient questions for the doctors at the conference. In her question, Kim asked, “Hi Adam, I have a bicuspid aortic valve with a valve size of .6 and a gradient of 80. When can I expect to have surgery?”
To answer Kim’s question, I was very fortunate to meet and interview Dr. Robert Bonow, who is a Past President of The American Heart Association and current Professor of Cardiology at Northwestern University. I have posted a written transcript of this video (below) for the patients and caregivers who are hearing impaired.
Thanks to Kim for her question and a special thanks to Dr. Bonow for taking the time to share his research and clinical experience with our community.
Keep on tickin!
P.S. Here is the written transcript of the video interview.
Adam: Hi everybody! It’s Adam with HeartValveSurgery.com. Today, we are at the Heart Valve Summit in Chicago, Illinois. I am thrilled to be joined by Dr. Bob Bonow who is a Professor of Cardiology at Northwestern Memorial Hospital and a Past President of the American Heart Association. Bob, nice to have you here.
Dr. Bonow: Thanks Adam. Happy to be here.
Adam: As you may know, we’re answering questions that were posted at HeartValveSurgery.com. Dr. Bonow we got a question from Kim. Kim writes, “I have a bicuspid aortic valve with a valve size of 0.6 and a gradient of 80. When can I expect to have valve surgery?”
Dr. Bonow: Great question Kim. The first thing that we always tell our patients is that we have no crystal ball. We don’t know all the ins-and-outs but we do know a lot about this condition. This is a very common condition and occurs in 1½ to 2% of the population. So, you have a very common condition. What I don’t know about you Kim — is your age, that is a factor, and, whether you want to become pregnant. Are you still in that time of your life where that is a consideration? That would be of some bearing. But, getting back to your question, you have a very tight valve — assuming this has been assessed very carefully and adequately and correctly. If that’s the case, you fit into a group of patients that has a very high likelihood of needing surgery over the next couple of years. You are likely to develop symptoms which could be shortness of breath, chest discomfort or light headedness. Or, the valve might get even tighter (aortic stenosis) with time such that your physicians would become even more concerned. Now, not knowing the discussions you’ve had with your doctors, I would say that it’s very important to have these discussion with your doctors. And, if you are not seeing a specialist in this condition – a cardiologist who sees lots of patients with aortic stenosis — then you should probably do that to really get more input as to what your next step might be, because you do have a high likelihood of requiring surgery and you want to be in the hands of people who know exactly the right things to do. And, if you do need surgery, the right surgeons to send you to so that you could have the surgery performed in a center where there’s very low risk and a very good outcome. So, in a center that performs lots of aortic valve replacement surgery, your risk should be quite low, with a very good long-term outcome. The important point is to have that discussion with your physicians to make sure that you are in the right safety net to have all the right things done. The other thing I should point out is that should you develop any symptoms, you don’t want to ignore them — and with this degree of aortic stenosis the chances are that you might develop symptoms over the course of the next several years.. It’s quite safe to wait until you have symptoms. But, as soon as you do have symptoms, it’s no longer so safe and that’s you when you clearly need to have the surgery done. In some cases, because of the high likelihood that this may happen in the short term, many times we recommend early surgery when the valve is this tight, because it is so predictable that it is going to happen at some point in the near future. Be certain that the measurements are accurate. That may require some additional tests to validate the current information you have and to confirm that the valve is indeed as tight as it appears to be. Then, have some very careful discussions with your physicians about the next steps.
Adam: Well, Kim, I hope that was helpful for you and also for the other patients who are watching this video. And, to you Dr. Bonow, I just want to thank you for all that you have done during your incredible career. It really seems like you have pursued healthy hearts your whole life. On behalf of the patients and the caregivers in our community, I just want to thank you for all that you’re doing. Thanks for stopping by and sharing this information with us.
Dr. Bonow: Thanks Adam. Keep up the good work and sending all the important messages out to the many patients who have valve problems.
Adam: Thanks so much.