Good news; bad news; good news.
The angiogram wasn't bad at all; most of the suffering was putting the second IV in low on my forearm.
The good news is that only one of the cardiac arteries was blocked, and that was in a fairly small remote section that feeds the back of the heart, the section of my heart that doesn't seem to be getting any blood according to the nuclear stress test. The other arteries of course all show some hardening of the arteries, as might be expected of someone my age and condition, but nothing terribly dramatic or justifying any immediate procedure.
The bad news is that the aortic valve is a lot smaller when open than the echocardiogram suggested: 0.8 cm² to 0.9 cm², rather than 1.3 cm². Cardiologist says that the longer I wait to get the valve replaced at this level, the harder it is for the heart to fully recover. He therefore suggests not waiting to get the aortic valve done.
The good news is that the heart surgeon explained that they don't actually have to open up my chest; they can do this through a space in the ribs and to the groin, and they've been doing this for a long time. Full recovery should take about four weeks. I am now working on straightening out details with my employer with respect to short term disability. The heart surgeon also says that women who have gone through this procedure say it was less painful than giving birth, and since I know that giving birth is less painful than a kidney stone, this doesn't sound hopelessly bad.
I am told that I will feel substantial improvement in my ability to breathe almost immediately upon recovery from surgery.
Additionally, while there roughly a .25% chance of the procedure ending poorly, I do not have the risk factors that account for most of the bad results. I am about 20-25 pounds overweight (not obese), I have never smoked, my kidneys are working just fine, and I am reasonably young.
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