Dilated aortic root

[dennie]

Hi, it is nice to find this place but I wish I'd found it earlier. Now I am seeing the surgeon in a few days and heading to OR in less than a week but still have some questions I hope can get some oppinions on before I talk to the surgeon.

I was diagnosed of a leaking bicuspid aortic valve 4 years ago with lv 6.4 and aortic root 3.8 already at that time. Now it obviously progressed that my lv is 7 and aortic root 4.5 now. There is no indication of aneurysm from my tests but I only had chest X-ray and echocard and I don't know if they can discover aneurysm at all. I am 30 year old male, good cholesterol level, 5'7 and 130lb. My questions are:

1. I am pretty much getting a mechanical valve but not sure if I need to have my aortic root worked on also?
2. How big is the chance that my aorta got damaged from the leaking aortic valve?
3. I know the lv will probably shrink a bit after surgery but how about the aortic root if nothing is done to it?
4. It seems that my surgeon is THE one to choose a certain model of valve for me. But how can I make sure he is getting a good model? Besides, how does he decide the size of the valve? I heard an incidence that the surgeon implanted a oversized valve and as a result, he removed some heart tissues to seat the valve which destroyed the heart rythm and caused damage to heart wall.

Thanks a lot.

 

[JimL]

Hi Dennie. My stenotic aortic valve had such a small opening that the blood was spurting out and thus enlarged the aorta. When the surgeon went in to replace the aortic valve, he also put a dacron wrap around my aorta to keep it the right size. I hope that helps.

 

[dennie]

Thank you very much for replying, Jim. May I know how much does this add to the risk of operation? How much longer does this make the operation? Besides, does it mean a minimally invasive surgery won't be applicable in this case? Thanks.

 

[JimL]

Dennie, sorry, I can't answer your questions. My surgery was over three years ago, and it took me a few months afterwards just to comprehend a little of what had been done to me. I know nothing about minimally-invasive surgery; some reason that it's good for the surgeon to have plenty of room to work inside, and that reasoning makes sense to me. The scar down my chest is no concern at all. I don't know how the surgeon got to my aortic valve; I assume he went through the aorta anyway, and so had to patch it up one way or another -- but I've never found out for sure how that all worked. You can talk to your surgeon and ask him all kinds of questions, but finally you put yourself in his/her hands, and in God's hands, and you wake up on the other side, glad to still be alive, and ready to enjoy every minute of life thereafter.

 

[Sir Reel]

I think you need to get the actual answers from your surgeon. There is no way for someone here to know whether and to what extent your aorta enlarged and if the enlargement was small enough so that the vessel was not permanently damaged.

Three years ago, I had my aortic root replaced (along with the valve - pig valve) with dacron due to the blood vessel having been stretched so much (mine was stretched a lot!). It obviously adds to the operation - time, complexity, and risk - but if you need it then so be it, plus I don't think it makes the surgery a whole lot worse. I wouldn't stress over it - it is what it is.

In my mid-late 40s at the time, I returned to an active lifestyle fairly quickly after the operation and have no noticeable effects from the operation other than I take blood pressure medication to keep the pressure down and am not supposed to lift more than 75 lbs.

Good luck. It is a lously thing to need but you have to do it. You should survive and do just fine. Get a good surgeon, follow the advice of the surgeon and your cardio, take your painkiller meds after the operation, start walking and build up your exercise, and in 4-6 months people won't know that you had the surgery.

 

[KathyH]

Dennie, I was able to have my aortic valve replaced and my aneurysm repaired with a minimally invasive surgery. I'm sure that it adds some time to the procedure, but it is really alot less painful. Keep in mind that not all surgeons do MI surgery.
Kathy H

 

[dennie]

Hi, Kathy, may I know how the repair was done? What is its effectiveness? Does another surgery later on necessary? I mean, the mechanical valve is supposed to last very long but how about the repaired aorta?

Did your surgeon decide to repair the aorta before the operation? It seems to me that some surgeons need to see the aorta to decide if something needs to be done to it. I guess it means it can not be minimally invasive other wise how could the surgeon see the aorta? Thanks.

 

[ar bee]

aortic root size

aortic root size

i saw my cardio today, most values stable (LV app 6.3), aoric root at app 3.95, free of symptoms, however the cardio suggested to move ahead with the AVR, simply because replacing both makes it a more complicated exercise!

well2u
ar bee