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Forum Name: Valvular Heart Diseases

Question: Severe aortic stenosis


 hsmith - Fri Aug 06, 2004 11:08 am

My husband has a "severe aortic stenosis" which was detected several years ago and has been progessing. Unfortunately, he is also fighting metastatic gastric cancer, which returned only recently, five years after a curative gastrectomy. The cardiologist was waiting for symptoms before performing a valve replacement. Oddly, despite these problems, he is living a relatively active life--still playing 18 holes of golf without a cart while on chemotherapy! The doctors can hardly believe that he has no symptoms from the stenosis--the fatigue he feels seems to result from the cancer and the chemotherapy, not his heart. He has always been very strong and physically active. I am afraid that if he does start to feel short of breath, or dizzy, that they will not do a replacement, since he will "probably not survive the cancer more than a couple of years at the most." I guess this will be a question for our HMO. But if symptoms do develop, will he be able to function at all without surgery, or is he likely to become a total invalid at that point? He is responding already very well to the chemo, after only one cycle. But they say "there is no correlation between remission and survival" so I am at a loss to know what is likely to happen, with either condition.
Harriet
 Dr. Yasser Mokhtar - Fri Aug 06, 2004 3:07 pm

User avatar Dear Harriet,

If your husband starts to have symptoms of critical aortic stenosis, then at this time surgery has to be done. It is not an easy surgery and it will depend on the health of your husband at the time and whether or not he is fit for this kind of surgery. If he is judged to be fit for surgery, a coronary angiogram has to be done as well and if a bypass is needed, it will have to be done at the same time.

There is another alternative, balloon dilatation of the aortic valve. It is not a substitute for surgery but it is used in cases where surgery is not feasible. Its main problem is recurrence of stenosis in 50% of cases within 6-12 months and recurrence of symptoms in 30% of cases within 6-12 months as well.

Nobody can predict when your husband is going to need surgery for aortic stenosis and when he does will he be fit or not for surgery at that time and where his cancer will be, so i would recommend that you deal with one problem at a time and not worry about the crossing the bridge before reaching it because you have too much to worry about now already.

But personally, if your husband starts to have symptoms of aortic stenosis and proves to be fit for surgery then, i would recommend going with surgery.

i wish you and your husband well.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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