I can’t believe I’m here again and discussing this topic. In April 2011, I was diagnosed with an ascending aortic aneurism and bicuspid aortic valve at the age of 50. My entire ascending aorta was twice the normal diameter, ~ 5.2/5.3cm. I could not believe it as I was in great physical condition, very active and never smoked. My argument at the time was, “how do I know this is not a normal size for me”? I am tall (6’) and lean. I had no baseline or echo’s from earlier ages, so nothing to compare and not able to determine rate of size increase.
The decision was made to monitor and do regular echo’s every 6 months. The cardiologist was concerned and suspected possible Marfan’s type tissue disorder. Which seems typical per literature when combining the BAV and AAA. Almost 2 years later the echo revealed a size of 5.5/5.6cm. A TEE was done and essentially confirmed the size, and BAV.
Living in the Pittsburgh region, I started research and came upon the great Cleveland Clinic. Scheduled a consultation and met with the infamous Dr. Lars Svensson. He recommended surgery as soon as possible and would perform the “key hole” or mini-sternotomy. He knew that I was not excited about getting a mechanical valve along with Coumadin and the tissue valves had a short life span. I left it up to Lars to make the decision on the valve when he was able to visually inspect it.
Surgery was done in June 2013. The ascending aorta was replaced by a Dacron graft. Upon aortic valve inspection, it was confirmed that I have a very rare unicuspid aortic valve. Lars determined that the valve was healthy and functioning, so he left it alone. The surgery was successful with a quick recovery and back to a normal active healthy lifestyle.
I had an echo done in Dec 2019 that showed moderate stenosis of the aortic valve, but I still felt fine. Over the past 8 months I could feel slightly more tired and winded especially when exercising.
The event. On Dec 13th 2020, after a long workout (i.e. 60 min. elliptical, 30 min. weights and abdominals, & 15 min. in hot dry sauna) I had a “syncopal episode”. The first ever for me. Passed out suddenly, hit a nice sharp object on the floor and caused a head injury which required a trip to the ER and sutures. I’m not sure how long I was out, but nice puddle of blood on the floor. Had a follow up echo which showed severe stenosis of the aortic valve.
So, now I’m looking at and researching valves and method of surgery. It appears that the best option may be the On-X valve. I’m really regretful that I did not have it put in last time, because it was available but I was not aware of it at the time.
I’m currently in the process of scheduling the consultation with Cleveland again. I’m so happy that Lars is still working his magic!
I’m open to any and all suggestions and recommendations. I’m also curious about others who may have gone thru similar circumstances. Thanks!