After Aortic Valve Replacement - Pulmonary Edema Persists

Question

Asked by MajorHart

After Aortic Valve Replacement - Pulmonary Edema Persists

In november, 2007 - I had my aortic valve replaced. I have had high blood pressure for 25 years but it was usually well controlled. I've always (over 50 years) been a jogger, walker and weightlifter. The cardiologists and surgeons said the exercise and attitude I had made their job much easier and at 70 years of age - I had just worn the valve out. They recommended that I go right back to the exercise. Two days after getting home I was walking 1/2 mile a day on my treadmill and within a week - 1 mile.

When I went in to the VA hospital I had been losing the ability to breathe rapidly - it declined from me being able to walk or run 1.5 - 2 miles - down to less than 1 quarter mile. We went to the hospital and I had an oxygen saturation rate of 79. They kept me there and over the next two days of intravenous lasix, I dumped so much fluid they were able to take me off oxygen. Then they sent me home to wait for scheduling the surgery. I did fine for 3 weeks - walking alot but not lifting weights - as I was told to not do that. Then I got my surgery.

I got a bovine valve and since then I've done very well and walked 1 - 2 miles almost everyday - with a few days of laying off now and then. My oxygen saturation is regularly between 92 and 97.

I had lost 25 pounds while in the hospital and have not gained it back but I do eat out occasionally and eat alot of salt. I'm 6' and weigh 195 and want to lose down to 170. I dont salt anything but eating out and various processed foods are very salty. So they keep seeing some pulmonary edema in my lungs. The cardiologist says it might be because of the recent valve surgery and he said it was getting better - but he is concerned enough to send me to a pulmonary specialist. I also take 20 mg lasix each day - they said to help keep my body fluids down. In the va hospital one nurse kept giving me intravenous lasix and another wouldn't give me hardly any water to drink. Obviously two different approaches to the problem.

My questions are these - I had LVH before and now they say I still have a little LVH. Could my heart have been in such bad shape before - due to the high blood pressure and bad valve (bleed back and not opening well) that I will have to build it up again with exercise and very low salt for a period of time? The Cardiologist said the heart and valve sounded really good. I do eat vegetarian alot too but now and then we eat very salty and fatty foods. If I'm doing 2 miles a day on my treadmill and lifting weights which they say is fine - how long will it take for my heat to build up the strength to expel that excess fluid from my lungs?

I am also a type II diabetic but my bg has been low enough that they want me to exercise and lose weight rather than take medication for it.

I am a member of the aortic valve replacement forum and regularly consult people that are going to have that procedure - paying back some of the help I've gotten and they say I am a terrific motivator.

So - should I just keep the salt and fluids way down and do a lot of aerobics? Will that strengthen the heart enough to pump out the fluid. I don't have much edema in the legs if any.

Any information or advice appreciated.

John Hansen majorhart@sbcglobal.net

Answer

The heart is essentially a muscle. Like any normal muscle if it has to pump against an increased pressure it will get thicker or hypertrophied. When that increased pressure is relieved to a great extent by valve replacement, the muscle will likely go back to a more reasonable size and thickness. If the heart is otherwise healthy, then a low salt diet and exercise will likely be all you need. Bring up these issues with your cardiologist, who can better relate these thoughts directly to your situation.