rtblount

[rtblount]

I had mybicuspid aortic valve replaced with a St Jude mechanical valve about eight years ago. Works great. I was diagnosed with a ascending aortic aneurysm of 5.25cm a year ago. I had a CT scan two weeks ago and the aneurysm is still the same size. No change in a year. The cardiac portion of the scan indicated that my heart and the associated blood vessels are in near perfect condition for a 67 year old male. The aneurysm shows no thining
of the aortic wall. Have any of you had similar readings and did your aneurysm continue to remain the same size? Or did it start growing again after some time?

 

[CCRN]

Aneursym

Aneursym

Hi

I had my ascending aorta replaced when it was at 4.7.......but I'm probably a much smaller person. Size is relevent here. The only symptoms I had was a weird fullness feeling in my chest every once in a while. The first time I felt the feeliing it stopped me dad in my tracks as I was pushing myself up hill on a bike ride. It didn't hurt....just really strange as I had never felt like that before. I believe the rule of thumb right now is 5.0 to 5.5 for surgical intervention. Did your cardiologist order the scan? If so I would be sure your surgeon saw the report and get his take on it. ALSO....ask the doc to compare the scan to the size of your aorta at the point of your valve replacement surgery. (They can do this by digging up your pre-op cath.) This would give a good idea of the rate of dilation. If it turns out to be close to the same size it is now you should tell your surgeon "Lucy you got some 'splaining to do" asking why it was not addressed eight years ago preventing a second surgery.....if indeed it is indicated. Hope this helps.....and, don't worry.....it's good you're being monitored so well.

 

[Ross]

Mine ruptured at about 4.7. I never made it to the gold standard of 5 for surgery and your beyond that! May I ask what they are waiting for?

 

[rtblount]

rtblount

I've been waiting on the advice of my cardiologist and a surgeon that he referred me to. They both agree that the aortic wall looks good and that they don't want to invade my chest again unless the aneurysm is growing. I am nervous about it but the cardio continues to advise me to wait until it gets to at least 5.5cm and he thinks it may not be growing at all.

 

[CCRN]

Opinions

Opinions

Get a second surgical opinion. I'd find a doc who does a lot of aortic surgery. Call Cleveland clinic. I don't recall where you live but if you're in range of Nashville, TN we have quite a few docs who regularly do Bentals, aortic repair and redo operations. Your guys might be right to continue to watch but it might make you feel better to know it is also the opinion of another surgeon with no affiliation to the current opinion. The psychological aspect of "wait and see" can be horrible....I know. I've been there. There is a light at the end of this tunnel. Hang in there.

 

[csutherland]

Jerry's ascending aortic aneurysm is also 5.2 - 5.3 and has remained so since being discovered in Jan '05. He did get a 2nd opinion from a St Louis surgeon who is renowned in the field and he agreed with our local drs to wait & see. In Apr he even said to extend the next CT scan to 9 mo vs 6.

 

[rtblount]

ascending aortic aneurysm

ascending aortic aneurysm

Thank all of you for your information. I visited the cardio Friday and he told me that we didn't need to schedule an appointment or another CT scan for a year. I don't know whether to feel good or bad about that. I plan to check out getting a second opinion. I live in south Georgia so I'll probably check out Nashville or somewhere close for a second opinion.

 

[PJmomrunner]

I can empathize with your not knowing whether to feel good or not about waiting a year for your next CT. Why don't you contact your surgeon from 8 years ago and find out how big your aorta was then? Then you'll at least know what its expansion rate is. It's possible that, if there's no growth in the last year, it's just not growth that's discernible from the limitations of the machine. (e. g. the machine's accurate to within 1mm and you measured the same both years, but the 2005 measurement was off by 1mm on the high side and the 2006 measurement's off by 1mm on the low side...or whatever...I'm not quite sure how to convey what I mean, but I hope you get it.)

Personally, I suspect the expertise of the surgeon you choose for your second opinion is going to have a lot to do with what his size criteria is for operating on your aneurysm. Surgeons who repair a lot of aortas and who have a high success rate will operate at a smaller size simply because your odds of making it through surgery in their hands are judged to be better than your odds of dissecting. For that reason and because it's a second surgery, I think you should seek out someone who only does valves and aortas and who has done lots of them. It is also possible that, while most of us who have had AVR and aneurysm surgeries (or are waiting for same) were given 5cm as the "magic number," that number may be different for a second surgery. I would ask both surgeons (the one you've already seen and the one you're going to see) if that's the case.

Hang in there.

 

[Mike C]

Make sure you get that second opinion.

You are very near if not in the range for surgery and should be watched closely.

It will continue to grow, although maybe very slowly. Even normal aorta's grow as people age and yours is not normal.

Also, I am a little skeptical of them saying it is not thin, meaning it is difficullt to tell how thin it is or not. If you could easliy tell it would make it much easier to say when to have surgery for lots of people.

 

[rtblount]

Ascending Aortic Aneurysm

Ascending Aortic Aneurysm

I thank you and PJmomrunner for you advice and comments. I think I will contact the Cleveland Clinic for a second opinion as I want to be certain I am dealing with an "aortic center".

 

[PJmomrunner]

I'm glad you're pursuing a top-notch second opinion, rtblount. I trust you'll keep us informed.

Also, I am a little skeptical of them saying it is not thin, meaning it is difficullt to tell how thin it is or not.

I thought this too, but didn't comment because I really don't know how difficult it is to discern thinness/thickness. No one has ever commented on aortic arterial wall thickness to me except to say there's a spot where the "eccentric" stream of blood hits my aneurysm that's cause for concern if I were to continue to run.