Aortic Regurgitation, Stenosis, Aneurysm

What does AV "regurgitation" mean? That's when the heart valve doesn't close all the way and some of the blood that the heart pumps each beat leaks back in to the lower chamber (ventricle) and the heart has to re-pump it. This puts additional strain on the heart. I have only mild regurgitation.

My aortic valve has a different primary problem: stenosis. This means that it is stiff and calcified, and the opening is reduced in size so the heart has to pump much harder to get the blood through the narrower opening. I do have severe level stenosis for my body size. This often happens with bicuspid valves. This will trip the surgery wire, I believe. My aneurysm, while significant, in and of itself would not be enough to warrant surgery at this time. What they would do if I had only the 4.3 mm aneurysm is to manage it with blood pressure meds and monitor it carefully with surgery only if it grew fast or larger.

But people with bicuspid valve disease usually end up having the valve replaced when it becomes severely stenotic. In my case, when surgery happens I will have the valve replaced as well as surgical repair of the anuerysm. This is complex surgery that really can only be done at a major thoracic surgery center like the U of P, and by an experienced surgical team, so I'm lucky. In order to do this surgery they not only have to use a heart lung bypass machine, but for a time, hopefully less than 40 minutes, they have to stop everything and there is no circulation of blood through the body. They can do this by inducing a state of hypothermia...cooling the body down drastically. When everything is stopped, they replace the part of the aorta that has the aneurysm with a sewn-in dacron graft. Then when they're done they put the patrient back on the machine or re-start the heart. It's amazing stuff and the survival rate is very good.