Interesting News From Cardiologist – BionicOldGuy

A couple of years ago, my yearly echocardiogram showed a mild amount of leakage around the outside of my aortic valve replacement. This is a fairly common complication.

Leakages cause regurgitation, which when some of the diastolic pressure when the valve is closed leaks out while the left ventricle is filling. Since the condition is mild and asymptomatic, we went into wait and see mode. Recently my follow-up two years later showed the condition has progressed to moderate. There is still no need to do something because I am still asymptomatic, so we’ll check again next year. If it has progressed, I may have to do a procedure. The minimally invasive approach is to go up from the groin through the femoral artery with a plug, which sounds similar to an o-ring. This has about a 70-90% success rate. The more invasive approach would be open-heart surgery, taking out the first replacement valve and putting in a new one. This has the advantage that valve technology has improved two ways since I got mine in 2017. First, instead of a hard plastic ring around the outside, the outer cylinders can now stretch a bit. This would be important if I ever needed to get a new replacement in the future. TAVR! The second improvement is the valve material, bovine in my case, is now treated to prevent calcium accumulation, making valve failure less likely. An extensive report from Google Deep Research on the options is presented here. It appears there is also additional imaging and other diagnostics that can be done to help choose which procedure. We’ll face that in a year or so if the condition progresses.

After seeing my Doc I later realized I might not be totally asymptomatic. A couple of time recently, while going really hard on long intervals I’ve gotten a bit out of breath. That rarely happens to me biking, usually it’s burning in the legs that causes me to back off, not getting out of breath. Getting out of breath is one of the symptoms of valve leakage. I’ll bring this up with my cardiologist and see what he says. In the meantime I will simply avoid doing long hard intervals, and follow Clarence Bass’s advice to either train long and easy or hard and short, or as Clarence puts it “I walk or I sprint, I don’t do anything in between”. Also, I’ve told my cardiologist that I bike about 90 minutes a day on average, plus throw in some sprint training. He thinks that amount is fine for now. But I must admit that lately I’ve been exceeding that pretty regularly. So I think I will cut back to the amount my cardiologist thinks is OK.