Aortic Aneurysm Advice

[weekycat]

For those of you who don't remember me from a few years back, my name is Jeannie and I had a mitral valve repair in 2002. Because it was a repair, and I am no longer even on medication, I haven't felt the need to visit this site in quite awhile, other than to check in on my heart friends now and then. I'm doing just fine, (although it's probably time for a check up). BUT...I just found out that my 79 year old mother has an aortic aneurysm.

She told me it is was at 4.1 cm a year (or 2) ago, and is now measuring 5.1 cm. She had an echo today, but hasn't gotten the results. She wants to put off surgery for as long as possible, but I thought that I remembered that anything over 5 cm was getting quite serious. She'd like to wait at least until next fall/winter, but I begged her not to put it off too long. Especially, in light of the fact that her father, (my grandfather) died of an aortic aneurysm at age 83. Of course, when I mentioned this to her she said, "Yeah, but he was OLD. I'm only 79." She's healthy, and quite active. She volunteers one day a week at the local Veteran's Hospital, "pushing men around," as she calls it. :biggrin2:

I know she doesn't want to undergo open-heart surgery, (I know first hand that it's not fun), but I'd really like to keep my mother around for awhile too. I'd appreciate any advice I can get from my very knowledgeable heart buddies. Thanks!

 

[ALCapshaw2]

Welcome Back Jeannie!

Sorry to hear about you mom's aneurysm.

The Gold Standard for viewing and measuring Aortic Aneurysms is either a Chest CT or Chest MRI.

Member Duff Man has posted images of his aneurysm a couple of times,
one recently so you may want to do a search of his posts to view it.

It would be wise for her to be evaluated by a Surgeon who has experience performing Surgery of the Aorta. I know there is an Aorta Specialist at the Mayo Clinic but have forgotten his name. I would not be comfortable going to a surgeon who only performs a few per year.

And yes, many surgeons use 5.0 cm as their 'trigger' for recommending intervention for an aortic aneurysm. Personally, I see little benefit in postponing the inevitable given that there is a risk of Sudden Death if it ruptures or dissects which those have experienced it describe as the Worst Pain they have ever felt.

'AL Capshaw'

 

[Duff Man]

Mayo clinic would be perfect for a surgical consultation and given her father's history and the rate of growth it should happen soon, IMO. 1 centimeter in a year is fast. One centimeter in 2 years is fast. I don't think she should be lifting anything heavy either -especially should not be lifting grown men. Please do not let her wait months for a consultation.

I'm curious to know if the modallities for the imaging of the aorta between last year's and this year were the same. For example, were they both CT Scan, or was one ct and one an echocardiogram?

I think I would be remiss if I didn't say that we have had at least one member who was in the same age bracket who had a very brittle aorta and it didn't end well. He ended up stroking out. Not trying to be scary, but sometimes it's better to wait. Only a surgeon or cardiologist can make that call. I should also mention that some locations of the aorta have different diameter indications for surgery. I think some abdominal aneurysms are like 5.5cm for "go time".

Here's my ascending aortic aneurysm:

 

[Duffey]

Hi Jeannie, glad to see you post but hate that it's for this reason.
I think the rapidity of the growth is more of a concern than the 5.1cm measurement. As Duffman said, there can be a discrepancy based on the test used for measuring the size. As Al mentions, an MRI or CT scan will be much more accurate than an echo. After she gets the results from the latest echo, a visit to a surgeon would probably be advisable just to get a surgical opinion.
I hope you keep us informed of what transpires.

 

[weekycat]

Thanks, Guys!

Thanks, Guys!

I'm going to have to ask her about the tests that were done, since she just told me all of this over the phone last night, and I don't remember for sure. I'm thinking it's a thoracic aneurysm, since she said it was pretty far up. I believe my grandpa's was an abdominal one. I would feel better too, if she got an opinion from a cardiac surgeon, whether it's at the Mayo clinic, or closer to home, in St. Cloud, MN. I sent her a link to this thread, so maybe she'll join in, and let us know the specifics.

This all comes as kind of a shock to me. A short time ago, it was my dad that was being considered for heart surgery. He has some pretty severe blockage in his arteries. However, because of other things going on with him, his cardiologist has decided that surgery might be a greater risk to him than NOT doing surgery at this time.

 

[scott.eitman]

From experience, I believe the Cardio should be the one to put the fear of G-d in her. When my Cardio told me last spring that I needed my valve re-replaced, I took him seriously, but hoped to put it off until Dec. When I called back to tell him that, I was told I would not be able to wait that long. He was correct.

I know listening to friends about issues that they know little to nothing about, does nothing to make me worry about things.

Scott

 

[ALCapshaw2]

By "pretty far up" does she / her Doctor mean in the Aortic Arch Area?

Surgery of the Aortic Arch is VERY Complex and probably beyond the comfort level of most Surgeons.
It would be best if she consulted with a Surgeon who specializes or at least has a LOT of experience doing Surgery of the Aorta. I'm thinking the Mayo Clinic would be the best place for her in MN (but confess I don't know a lot about the other options).

 

[texasmike]

Aortic Aneurysm

Aortic Aneurysm

My advice: go to Mayo, Call Dr. Hartzell Schaff. He did my aorta and AVR almost a year ago, and is (like all of their doctors) excellent!
Good luck!

 

[ALCapshaw2]

The Mayo Clinic CardioVascular Surgery Center contact number is (507) 255-2000 (from their website).

Their Website has a List of Departments and a List of Doctors (ALL departments)
but I was unable to find a List of Doctors by department. What an inconvenience!

 

[Lynlw]

The Mayo Clinic CardioVascular Surgery Center contact number is (507) 255-2000 (from their website).

Their Website has a List of Departments and a List of Doctors (ALL departments)
but I was unable to find a List of Doctors by department. What an inconvenience!

http://www.mayoclinic.org/cardiovascular-surgery-rst/doctors.html hopefully goes to the surgeons and http://www.mayoclinic.org/cardiovascular-disease-rst/doctors.html should go to all cardiologists that you can furthur break down by list of specialists http://www.mayoclinic.org/cardiovascular-disease-rst/doctorsbyspecialty.html
I hope. otherwise click on search for doctor then Minn and it should take you to the list oF depts to choose from

 

[weekycat]

I guess I will have to call my mother...

I guess I will have to call my mother...

I honestly have no idea what she meant by "pretty high up," but I'm going to give her a call. She's sort of new to all of this heart stuff, and wouldn't necessarily know the technical terms. Hopefully, she's gotten the results of her echo by now, too. I'll let you all know what I find out. Thanks again!

 

[weekycat]

Okay, here's the deal. I was mistaken about when she was at 4.1 cm. She had a Cat scan SEVEN years ago, for some other unrelated reason. It was written in her records, but my mother was never told about it (or if she was, she didn't have any idea what it meant) at the time. She had an MRI in January of this year, which indicated that it is now at 5.1 cm. This is why her doctor ordered the echo, which she had on Monday, but hasn't gotten the results of yet. And yes, she said she asked the echo tech where on her aorta the aneurysm was, and she explained to her that it was where the aorta loops around, on the curved part...which sounds to me like it could very well be on the arch. I did tell her that I had asked for advice here, and sent her the link. I told her I really don't want her to put this off too long, and she said she won't...but she has to get her income taxes done first, because no one else could possibly do them... That's my mother for ya!

 

[Duff Man]

Ok that's not as scary of a time frame for the dilation, but it's still in range for resection. That the least a consultation. Arch work is something you're going to want an experienced surgeon to do. Mayo sounds good.


Some people think it's a conflict of interest to see a surgeon for advice on when to operate - but my experience has been that they do NOT want to operate unnecessarily. I think they generally like being able to sleep at night and live with themselves.