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Dr. Mark
Dr. Mark, Board Certified Physician
Category: Medical
Satisfied Customers: 5560
Experience:  board certified internal medicine
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I am a 54 male with a bicuspid aortic valve and moderate

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I am a 54 male with a bicuspid aortic valve and moderate stenosis. I have had 2 electrocardiograms that attest to the fact. I went to get a physical 2 weeks ago and the doctor heard my heart murmur, but didn't seem too concerned about getting another echo. He asked if I had shortness of breath or any other severe stenosis symptoms, and I said no. Wondering... is surgery to repair inevitable or is there a good reason to wait?
JA: The Cardiologist can help. Just a couple quick questions before I transfer you. Do you know if your family has a history of heart disease? In general, how would you describe your health lately?
Customer: Great. My dad has never had any heart issues (I look just like him), my mom had a mild heart attach at 70 years old
JA: Anything else in your medical history you think the Doctor should know?
Customer: I have had elevated cholesterol but I do treat with diet, etc. I am 5'9", 172 lbs
Hi. There are criteria for doing elective valve surgery. Two common criteria are a valve area of 1 cm squared or less . Another is a gradient across the valve of 50 mm Hg.
They can detect these criteria among others on the echocardiogram. I assume you don’t meet any of these criteria now. So observation is all that’s required.
Surgery isn’t inevitable but often bicuspid valves due progress over the years.
Customer: replied 16 days ago.
If the disease is progressive anyway, wouldn't it make sense to fix before a more fatal issues happens like the aortic artery getting bigger, etc. or can stenosis stop somehow with proper diet, etc.?
Surgery isn’t done until the criteria are met. Not all bicuspid valves will need surgery. So no surgeon will operate until the standard criteria are met.
If it does progress, it occurs slowly over years.
Diet won’t have an effect of the valve. Controlling blood pressure is important.
Customer: replied 16 days ago.
My last echo had valve area at 1.2cm, peak gradient 40mmHg, mean gradient 24mmHg
Customer: replied 16 days ago.
no aortic regurgitation
For now the option is watch and wait. I’m sure that’s what you’ve been told.
Customer: replied 16 days ago.
also, it seems that I have a vertically oriented bicuspid valve - it was noted
Customer: replied 16 days ago.
one more question... how often should I get the echo test considering my condition?
I suggest every 6 months.
Customer: replied 16 days ago.
Do you know of a way I can schedule my own echo test or does it have to be called in through a doctor?
A cardiac lab will require a doctor’s prescription.
Customer: replied 16 days ago.
Can you provide a prescription?
Your doctor needs to do that. I’m not your treating physician.
Customer: replied 16 days ago.
OK - thanks
Customer: replied 16 days ago.
When you mentioned "gradient across the valve of 50 mm Hg", is that peak or mean?
Mean gradient.
Dr. Mark and 6 other Medical Specialists are ready to help you
Customer: replied 16 days ago.
Should I consider taking a 81 mg aspirin with aortic stenosis?
There’s no need . Aspirin is for coronary artery disease not valve disease.
Customer: replied 16 days ago.
Would taking it be beneficial anyway or a waste of money?
It’s not beneficial in any way for your valve.
Customer: replied 16 days ago.
What is the preferred surgery for aortic valve replacement these days? I read about TAVR, open heart, mini cut?
That’s a decision that the cardiac surgeon makes based on your valve and aorta.
Customer: replied 16 days ago.
Does the aorta typically get larger the longer a person waits after severe stenosis or after any stenosis is discovered?
No it doesn’t.
Customer: replied 16 days ago.
Does having a bicuspid valve effect the possible aorta size?
A biscuspid valve is associated with aortic dilation.