R
ross3
Hello everyone!
I?ve just joined because I have an enlarged aortic root and ascending aneurysm that needs repair.
I?d really appreciate getting all the advice that your collective wisdom can offer.
Here?s my story:
I?m a 57 year old guy whose father died at age 72 of a dissecting aorta. My dad?s aorta was enlarged and dissecting from the arch down through the abdomen and at the time (1987) it was deemed too extensive for surgery.
In 2004 I learned that my aortic root was 46mm via an echo screening. A re-check in 2005, again by echo, showed it to be 47mm.
This past December it measured 51mm by a poor quality CT scan.
Last Friday (the 13th!) I had a high quality MRI and the aneurysm measured 52mm at the widest part. It is slightly oval at this widest part (49mm x 52mm) and narrows down to 38mm before reaching the arch. After the MRI I met with a local surgeon at Duke (Dr. Chad Hughes) who confirmed my belief that it?s time to get this repaired. He said that even though the aneurysm ?hadn?t changed significantly in the past 6 months? I should move ahead with the surgery because of my family history.
Dr. Hughes feels that because my aortic valve is showing only mild to moderate regurgitation that I?m a candidate for a David procedure (he said ?David 5?), but that he wouldn?t know until I was already in surgery and he could assess the valve. I would need to have a pre-specified backup plan (i.e. ? tissue or mechanical, etc.) in case the valve had problems that precluded its use.
He specializes in Aortic repair and has performed a total of ~ 50 David procedures (this includes those during his residency at Penn). He also does ~100 other aortic root replacements, such as the Bentall, per year. He says that the combined mortality & stroke risk is only 2% based on his own surgical record. I would also be exposed to 2 ~ 3% risk of bleeding/infection and/or need for a pacemaker that he said is common to any type of heart surgery.
I am extremely encouraged by the statistics he quoted, particularly since the best comparables I?ve seen are from the Cleveland Clinic that show 3.6 mortality (on the web site).
Apparently my heart has some overall dilation but functions well. This dilation causes him to wonder if I may have some connective tissue type disorder although I have no other symptoms/characteristics that would suggest this.
My blood pressure at rest over the past few years has typically been 120/77. About two weeks ago I began taking a pressure lowering drug (Atenolol) that seems to have reduced it just a bit ? to perhaps 118/75. Lying down in bed it currently is running 105/65.
At this point I?m not sure whether I should go ahead and schedule the surgery with Dr. Hughes at Duke or whether I should search for other opinions.
Having the surgery locally here at Duke has its obvious advantages. On the other hand I?d ?go the extra mile? if there were any likelihood of a better outcome. I guess this is the same kind of decision that we?re all faced with so I?d appreciate any comments and suggestions.
For example, I?ve thought about writing to some of the other surgeons that I?ve read about (Dr. David in Toronto, etc.) to get see if they would suggest coming to see them, etc. However, assuming that the statistics quoted to me by Dr. Hughes are accurate I may be spending my energy/time futilely by pursuing other surgeons or facilities. I?d like to feel confident that the local route is best but am concerned that I may overlook a better option.
I look forward to being an active member here.
Ross Mann
I?ve just joined because I have an enlarged aortic root and ascending aneurysm that needs repair.
I?d really appreciate getting all the advice that your collective wisdom can offer.
Here?s my story:
I?m a 57 year old guy whose father died at age 72 of a dissecting aorta. My dad?s aorta was enlarged and dissecting from the arch down through the abdomen and at the time (1987) it was deemed too extensive for surgery.
In 2004 I learned that my aortic root was 46mm via an echo screening. A re-check in 2005, again by echo, showed it to be 47mm.
This past December it measured 51mm by a poor quality CT scan.
Last Friday (the 13th!) I had a high quality MRI and the aneurysm measured 52mm at the widest part. It is slightly oval at this widest part (49mm x 52mm) and narrows down to 38mm before reaching the arch. After the MRI I met with a local surgeon at Duke (Dr. Chad Hughes) who confirmed my belief that it?s time to get this repaired. He said that even though the aneurysm ?hadn?t changed significantly in the past 6 months? I should move ahead with the surgery because of my family history.
Dr. Hughes feels that because my aortic valve is showing only mild to moderate regurgitation that I?m a candidate for a David procedure (he said ?David 5?), but that he wouldn?t know until I was already in surgery and he could assess the valve. I would need to have a pre-specified backup plan (i.e. ? tissue or mechanical, etc.) in case the valve had problems that precluded its use.
He specializes in Aortic repair and has performed a total of ~ 50 David procedures (this includes those during his residency at Penn). He also does ~100 other aortic root replacements, such as the Bentall, per year. He says that the combined mortality & stroke risk is only 2% based on his own surgical record. I would also be exposed to 2 ~ 3% risk of bleeding/infection and/or need for a pacemaker that he said is common to any type of heart surgery.
I am extremely encouraged by the statistics he quoted, particularly since the best comparables I?ve seen are from the Cleveland Clinic that show 3.6 mortality (on the web site).
Apparently my heart has some overall dilation but functions well. This dilation causes him to wonder if I may have some connective tissue type disorder although I have no other symptoms/characteristics that would suggest this.
My blood pressure at rest over the past few years has typically been 120/77. About two weeks ago I began taking a pressure lowering drug (Atenolol) that seems to have reduced it just a bit ? to perhaps 118/75. Lying down in bed it currently is running 105/65.
At this point I?m not sure whether I should go ahead and schedule the surgery with Dr. Hughes at Duke or whether I should search for other opinions.
Having the surgery locally here at Duke has its obvious advantages. On the other hand I?d ?go the extra mile? if there were any likelihood of a better outcome. I guess this is the same kind of decision that we?re all faced with so I?d appreciate any comments and suggestions.
For example, I?ve thought about writing to some of the other surgeons that I?ve read about (Dr. David in Toronto, etc.) to get see if they would suggest coming to see them, etc. However, assuming that the statistics quoted to me by Dr. Hughes are accurate I may be spending my energy/time futilely by pursuing other surgeons or facilities. I?d like to feel confident that the local route is best but am concerned that I may overlook a better option.
I look forward to being an active member here.
Ross Mann
