Aortic Dilation/Replacement info needed

[Thwdp]

Hi

My Surgery has just been postponed for a month due to an angiogram showing I have a 6cm dilated Ascending Aorta. They are recommending graft replacement for the dilated aorta whilst I am in for my congenital bicuspid aortic valve replacement surgery (supposed to have been yesterday).

I already know a lot about my valve condition and the surgery for that, but nothing about this new condition.

I have been trying to find info about dilated aorta and replacement on the web but there doesn't seem to be much that I can find which isn't about (much scarier) aortic aneurysms or dissected aorta, etc. (there is always someone worse off I guess).

Any help in pointing me in a good direction for info on this in terms of stats, descriptions, things to look out for, how to look after myself pre/post op for this new area, success rates, etc. etc. would be most welcome.

Hope someone can help.

Cheers

Phil

 

[Tom F.]

An expansion of the aorta to 6mm is an aortic aneurysm. I assume that the aneurysm is in the ascending position, meaning next to your aortic valve. So that is an ascending aortic aneurysm. It is indeed a good thing that it has been identified and will be treated.

 

[Duff Man]

As far as success rates, well, you stand a good chance at living a normal life post surgery. Here's a study that consoled me when I thought I was "up to bat" for the procedure:

http://www.ncbi.nlm.nih.gov/sites/e...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

CONCLUSIONS: In patients with BAV, the Bentall procedure has an operative mortality no worse than that for aortic valve replacement, with superior long-term survival and a lower rate of aortic reoperation.

My impression is that it appears we're pretty darn close to the general population after we get it fixed if we survive the procedure:

I'm particularly good at worrying about risks and the like, but I assure you it's almost totally fruitless. The main thing to worry about is finding a highly competent and experienced surgeon to do the procedure in an institution that has a good track record. Everyone here will tell you the surgeon's level of experience with this particular procedure is directly correlated to survival. What I mean is, the more your surgeon has done it, the more likely you are to make it.

For what it's worth, my prospective surgeon at UofM said the mortality rate is about 1 or 2% in his care. Another renown surgeon said the procedure is essentially a slam dunk.

More than likely, if you're a younger guy or even if you're older and in decent shape... you'll make it. I see you like surfing so I imagine you're in good shape other than the aorta. Chronic diseases like COPD or coronary artery disease or diabetes increase the risk. If you smoke it's time to stop now.

Like Tom said, the risk of waiting is now probably greater than the risk of surgery. Elective surgery is done at 4.5 - 5.0 cm in people with no other risk factors. Sometimes smaller depending on the circumstance.

 

[skeptic49]

Great that you found out about the anuerysm. I have a similar condition to yours but my aneurysm is not quite as severe at 4.3 cm. Anuerysms often go hand in hand with bicuspid valve disease.

The first place to go is to look at the sticky in the bicuspid valve forum and follow the link to the bicuspid valve foundation. There is a ton of information there that will help you to understand your situation. I have been researching this all week. Let me know if I can help out with any additional infomation.

Best wishes,

Jim

 

[Phyllis]

If you put "dilated aorta and replacement " in the search box, I am sure you will come up with many on the forum who have had the aorta replaced as well. I will put you on the calendar for January 7th and wish you Godspeed!

 

[ALCapshaw2]

"Aortic Dilation" is a euphamism for Aortic Aneurism.

You can learn a LOT about that condition, and why it has a high correlation to Bicuspid Aortic Valves in the Bicuspid Aortic Valve and Connective Tissue Disorder Forum.

It is in your Best Interest to find a Surgeon with extensive Experience doing Surgery of the Aorta.

'AL Capshaw'

 

[Thwdp]

Thank you all - that has given me a few good places to head to for more info in the meantime.

Cheers

Phil

 

[tobagotwo]

A 6.0 Aortic Aneurysm would normally push you up on surgery, rather than delay it.

It's scary to think about, but it's a common procedure to replace it - and once it's replaced, it's done. Usually they use a tube of dacron or velour that your own cells actually grow into (with tissue valves, a short run can be done with natural aorta, such as with the Medtronic Freestyle valve). The fabric becomes yours as it heals, developing a proper endothelium. That takes about six months or so, during which you won't be able to have dental work or other intrusive procedures done without IV antibiotics, and will probably be taking extra anticoagulants.

However, you don't want to wait for it to dissect before it gets replaced. So I would encourage them to set up the schedule again, or seek a place that does more of this type of heart surgery. Not at all trying to scare you, but you should continue to move forward at this point.

The longer term thing is to get the rest of your arterial system mapped out, to ensure it's limited to that area. Often, it is, but you'll probably want to know.

Best wishes,

 

[Superbob]

I'll echo what Bob just said. I had the dilation, which was monitored very closely by cardio with surgery done when it hit 5.3 (on day of surgery, they found it to be 5.5). I have the Medtronic Freestyle, and am happy with it so far. There are other good options -- discuss them with your docs and do some searches here.

I agree with Bob that it sounds like the schedule ought to be expedited. No panic -- high success rate with the surgery, just don't want to unduly delay.

All best wishes to you.

 

[Fran]

Hello! I had the dilatation as well, in the ascending aorta, and that actually sped up my surgery date. My wonderful Dr A said, "You can wait a month, but I wouldn't wait six [mine was at 5], but I get the feeling you want this done yesterday" and boy was he right! They grafted mine with the Dacron, I'm as good as new as far as that's concerned, when he replaced my leaky bicuspid valve with an Onx valve.

You're going to feel so much better. Your blood's not getting where it should, and it's so hard functioning with less O2 than one is meant to have! Hang in there, the worry and fear are really the enemies here. You will be walking and busy and feeling marvelous again soon.

My surgeon showed us a picture from an older patient's aneurysm, it was shaped like a pork chop, Dr A said they had the six-hour window after chilling this man's body and putting him on the bypass - that the aorta had tried to mend itself so many times that the tissue was like "stitching in wet Kleenex [facial/nose tissue bran]!" And they went past the 6-hr window, but this 71-yr-old at his one-month checkup was so good to go. They can do almost anything in there. Have faith and courage and strength. I just numbed my brain out as much as I could once I'd studied and tried not to ruminate. You can think about this stuff almost TOO much and freak. Freakin' out is NOT good. Cool, numb, detachment until it's over is the way to go. All my best...