Mike's Journal

I have aortic stenosis and likely either a bicuspid valve or a valve where two flaps have fused together. I am in the watchful waiting process with echos every year and I am in the moderate close to severe rating. I had a second opinion via a virtual visit with a heart valve surgeon that appears on this site often. At my last visit with my regular cardiologist, I asked if he had reviewed the report of the second opinion and he had but gave it very little consideration. He said that when it came time for surgery, he highly suggested I use the local surgeon he recommends. He stated that patients that decide to go out of state to some of the more well known centers, will have trouble getting assistance from cardiologists back in their home state as they won't be willing to take on potential problems created by another out of state surgeon. Just wondering if those that have gone out of state to get heart valve surgery have encountered any issues with getting assistance from their local doctors if necessary.

https://www.fda.gov/medical-devices/letters-health-care-providers/abbott-trifecta-valves-potential-risk-early-structural-valve-deterioration-letter-health-care

Adam: I am a 58 year old male in fairly good health. Four years ago after having an Echocardiogram, I was diagnosed as having a bicuspid aortic valve with some stenosis. It was considerd in the mild range. Two years ago another Echo showed basically no change. It has been two years and I am going for another Echo this week. Over the past couple of months my blood pressure has been higher than normal about half of the time I have checked it (130-150 over 80 - 90). About half the time it is in the normal range. Also, I almost always have high “white coat” blood pressure when checked at a doctor’s office. This background leads to three questions: 1) I have read scholarly medical articles discussing how blood pressure can indirectly affect the assessment of aortic stenosis severity through concomitant changes in transvalvular flow. Have you ever had a discussion with cardiologists about this issue and can you offer any input? 2) Is an echocardiogram a sufficient diagnostic tool for someone monitoring mild aortic stenosis with a bicuspid aortic valve? Or should I be pushing for another diagnostic tool? 3) I have been using the same large medical practice for many years where cardiologists seem to come and go. I am about an hour and a half from Dr. Kevin Accola’s office. Given my “mild stenosis,” would it be too premature to consult with Dr. Accola? Thanks, Mike