Bryan's Photos

Thanks. I'd like to get it done ASAP but I was recently told June, July, or August. It's hard to say because nothing like this has ever happened before. I had a CT scan done about 2-3 weeks ago and arteries and heart look good besides the valve regurgitation and mild left atrium enlargement. I feel like my chest pain discomfort is worsening. Did any of you experience a nagging chest painspre-surgery? Not quite painful, but uncomfortable. I was told waiting another 4 months will not be an issue, but the unknown waiting period is annoying.

My coronary arteries were also fine, the pre-surgery angiogram showed. So nice not to have to worry about that. Shortens surgery time. But my mitral valve had a "flail" leaflet, with a chord or two broken. So it was flapping in the breeze in there. So the valve dysfunction was pretty severe, with severe regurgitation. This severe situation did cause me some nagging pressure or ache in what I thought was my lower lungs -- because people thought I had pneumonia at first. A common misdiagnosis. (They probably should have gone straight to a fresh echo to check the heart when I had shortness of breath/ coughing from "pneumonia," because my mitral valve prolapse was a known problem.) So yes, I had a pain down there. I will say that my left atrium ballooned to 4x its normal size pre-surgery, and I also developed severe pulmonary hypertension. The pressure in that vein should be basically 0 between beats and mine was 75. That's just a result of all that backpressure. There is no valve between the left atrium and the pulmonary vein, so left atrium enlargement / dilation is happening at the same time as that pressure is being transmitted back into the lungs. It will ultimately show as right ventricle enlargement also, as it gets harder to push blood into the lungs against that backpressure. Upon repair of my valve, my LA volume came down to HALF its pre-surgery size immediately (lying on the table, measured with a fresh echo before they finished). And presumably that pulmonary hypertension resolved immediately also (that's kind of impossible to measure directly without a catheter stuck in there). The RV enlargement has gone away now (last tested at echo 13 months post surgery, and I'm at like 20 months now), but the LA is still enlarged, not quite double normal but just under that. My cardiologist says at this point it has probably come down ("remodeled") as far as it will. We don't know what damage that pulmonary hypertension did while it persisted (we guess the valve was "flail" for just over a year), but conceivably there is some impaired lung function as a result of that era. So I guess the point is that my situation was not diagnosed quickly, with definite long-term enlargement to at least my LA. If I were you, I would assume that chest discomfort is a combination of the LA enlargement, some pulmonary hypertension, and maybe some RV exerting itself. I know the delay isn't of your own making, and there's no reason to freak out (I had to wait 45 days after diagnosis to get in with my preferred surgeon); but I would take the first available table.