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View Full Version : Pre surgical question Dr. Fett


melissamph
04-07-2005, 09:13 AM
Hi Dr. Fett,

I am nearly 3 yrs post diagnosis. Having no symptoms at all. I currently take 25 mg Coreg BID, 10 mg Altace qd, 40 mg Nexium qd, 500mg Metformin BID and 81 mg Asprin each day. I currently weigh 251 and am having a Gastric Bypass on April 19th. My echo at diagnosis (9/11/02) was 30-35%EF and at 6 mos. was 45-50% and then at 1 yr. it was 55%. My question is should I ask for another echo to be done when I meet with the anesthesiologist? My surgeon said that reviewing my reports it showed PPCM was resolving and that another isn't necessary prior to surgery. EKG was fine. CXR normal. Upper GI fine for the most part. Blood work good but anemic. Slight elevation of CO2 by only 2 pts. so she said that was fine (could be calibration and not a major concern at 2 pts.). I have had 2 surgeries since the delivery of my 3rd child. The first was a hernia repair and it was at 11 wks post partum and I hadn't been diagnoses yet and did well in surgery the second surgery was a year later and was a lap choley and did fine. So, we have no reason to think I won't do fine but just concerned since the last echo was 2 yrs ago this month. I have all of my measurements and flows. My cardio's summary: L ventricle is slightly dialated (6.1), though the LV EF continues to improve to 55% from 45% months ago. So do you think I should ask for another echo prior to surgery? Thanks in advance! Melissamph (old boards Melissa C).

JAMESFETT
04-07-2005, 05:39 PM
Hi, Melissa. Here are prayers and best wishes for surgery. I think your anesthesiologist will advise you best, and I expect you to tolerate the surgery very well. In following previous PPCM patients we do focused echos for LV size and EF at 6 months intervals, which is not very expensive to do; not the entire formal echo, which is expensive. With a 2-year gap, we would certainly do a "quick-look" echo to know where you are at pre-surgical--also in the unlikely event that there would be any complications, and then we would have said, "oh, we should have checked before surgery." I wish more US cardiologists did office echos, that way they would have more frequent looks, and it would not cost so much for insurance companies or patients.

James

tabs
04-08-2005, 07:29 PM
Melissa,

I, too, have had many surgeries post PPCM. Only one aenethetist was worried about my EF and that was within 5 days of dx with the ef of 7%. After putting me under (lightly), he did a TEE (transesophegeal echo) to see me heart function for himself before the rest of the surgery took place.

Twilah

melissamph
04-09-2005, 09:22 AM
Thank you both for your helpful insight. I am meeting with my anesthesiologist on Tues. afternoon and I will update on his decision on Wed. Then it is surgery on Tues. the 19th!