I recently read This I Believe: The Personal Philosophies of Remarkable Men and Women, where average Americans wrote their personal credo. I suppose my credo is that people are inherently good, and that, given the opportunity, people are incredibly willing to inconvenience themselves in order to simply "help" others.
A decent portion of the day went to following up on subvalvular web leads.
John Ho, M.D., a cardiologist at Cooper Clinic was kind enough to talk with Keith and I both about the condition. Dr. Ho explained that blood from the heart goes through the Left Ventricular Outflow Tract (LVOT) and out the aortic valve.
In Keith's case, blood is having a problem getting from the main chamber of the heart to the aortic valve. This may be due to the web, the membrane, or an entire thickening of the whole tube that the blood is going through. Over time, this type of obstruction tends to worsen. This can lead to a strain on the heart, sometimes to the point of heart failure.
Dr. Ho says a balloon or open heart surgery are the options for fixing this, and that the best method is open heart surgery. (My Google search backs this up - Mayo Clinic and a couple of research papers I've seen say the balloon procedure is not nearly as effective as surgery...., although even with surgery we should anticipate that Keith may need to have the surgery again as it's not unusual for the problem to crop up again.) The point of fixing it now versus later is that hopefully we can get it fixed before Keith's aortic valve gets destroyed by the "turbulence" in the area.
Dr. Ho says the surgery is most often found in pediatric cardiology, a statement that was backed up by Cousin Sarah and her review of medical codes later in the day. (Sarah also gave us a lead on a pediatric cardiologist - says they will often work with adults too.)
I digress. Last week Dr. Stoler said we need to get an ECHO. According to the Mayo Clinic web site, "An echocardiogram uses sound waves to produce images of your heart. This common test allows your doctor to see how your heart is beating and pumping blood. Your doctor can use the images from an echocardiogram to identify various abnormalities in the heart muscle and valves."
Dr. Ho agrees we need an ECHO and says that Dr. Paul Grayburn, the guy recommended by Dr. Stoler last week, is good at his craft. Keith phoned the scheduler, and Dr. Grayburn is back at work (was out last week with eye surgery) but we don't have a appointment date or time yet. Maybe tomorrow that piece will get done.
When we go for the ECHO, we need to remind Dr. Grayburn and the technician that there's consideration of a subvalvular web, and have them look at the gradients and pressure. Once this test is completed, we can send the ECHO results and the data from the cardiac catheter last week to Dr. Ho and he'll review them.
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