Michael E. Stachecki, MD
Specialty: Internal Medicine
- internal medicine
Location and Office HoursMichael E Stachecki MD
5885 S Main St Ste 3
Clarkston, MI 48346
- BlueCross BlueShield
- BlueCross BlueShield of Illinois
- BlueCross BlueShield of Michigan
- Great-West Healthcare Cigna
- Priority Health
- United Healthcare
- Crittenton Hospital Medical Center
- Genesys Health Park
- St Joseph Mercy Oakland Hospital
Will I be awake during cardiac catheterization?
Yes. You will be given a mild sedative to help relax you, but it is always better if you are able to tell your physician if you are having any discomfort or shortness of breath during the procedure as it is performed. Your doctor will also use a local anesthetic to numb the site where the catheters are inserted, usually in your groin or in your arm. The procedure itself usually takes about 15-30 minutes for diagnostic test but may take substantially longer if a procedure requiring stenting or ballooning is performed.
Is it better to repair or replace a rheumatic mitral valve?
This depends on whether the valve is also regurgitant, the age of the person and whether later pregnancy is a planned.
In mitral stenosis the leaflets are thickened and hardened with calcium deposits, so it can be difficult to achieve a durable repair. If the valve is also regurgitant (not pure stenosis) then repair may be a reasonable option. Even when the valve repair appears to be successful, however, rheumatic disease may progress, resulting in regurgitation or stenosis a few years later, which may mean repeat surgery.
Even so, valve replacement carries a worse long-term survival and complication rate than repair. The risks of stroke, and valve infection, as well as the risk of dying are all higher after mitral replacement compared to successful repair. People who have mechanical valves must take Coumadin for life, which can cause bleeding, can damage the unborn child, and must be monitored with regular blood tests. Biological valves last 8 – 12 years on average before they need replacing in young patients with mitral valve disease. So a valve repair, or a biological valve may be a reasonable option in a young women who may later become pregnant.
What is trigonitis?
Despite its name indicative of inflammation, trigonitis is a metaplastic process. The exact primary cause is not known, however, squamous metaplasia in the bladder usually occurs in response to an irritative (prolonged indwelling catheter placement) or infectious process. The occurrence of trigonitis varies according to many reports. Non-keratinizing squamous metaplasia of the bladder neck and trigone can be seen in 50-70% of premenopausal women and is considered a normal variant. Trigonitis, or non-keratinizing squamous metaplasia, is considered nonthreatening and without malignant prospective.
Nevertheless, it must be distinguished from keratinizing squamous metaplasia, also known as leukoplakia. Leukoplakia is thought to be a reaction of the normal urothelium to harmful stimuli and is commonly considered a premalignant lesion that may develop to squamous cell carcinoma in 20% of patients. Squamous metaplasia of the trigone is nearly absent in children and it appears virtually exclusively in women of reproductive age.
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