Just finished a TEE procedure and it confirmed the need for aortic valve replacement. My aortic root is 3.8cm in diameter. Cardiologist didn't discuss this. What is considered normal (if there is such a thing as "normal")
I will start out with my very inexpert understanding.
First, of course this will vary somewhat with the size of the individual. In general, though, my understanding was/is that 5.0 is the point at which the aortic root is considered dangerously enlarged (may be less than that for some individuals). Mine was 5.5 at the time of surgery.
I had a combined aortic root and valve replacement.
Of course you can have a leaky/defective valve in need of replacement without necessarily having an enlarged aortic root.
I am sure people better versed than me in these technical details will show up. Just wanted to give you my understanding.
Normal is a relative term when it comes to "normal" aortic root size. Normal size can be affected by gender, the person's size and overall BSA (body surface area), and somewhat by outside influences like hypertension and pre-existing aortic valve disease.
I have read that the normal size of the aortic root can be anywhere between 2.0cm and 3.8cm depending on the criteria listed above and which article you read. For the most part though I have read that 3.5cm is usually the cutoff for the upper limits of normal and anything higher than that is classified as being at a certain stage of dilated.
Since my Ross Procedure in 2004 my aortic root has been measured by echocardiogram during yearly followups and the measurements have been 3.5cm, 3.7cm, 4.0cm (echo redone after this reading and was remeasured at 3.8cm), and recently 4.3cm. They reported my aortic root as normal at 3.5cm, mildly dilated at the 3.7cm and 4.0cm/3.8cm, and dilated at the 4.3cm. My cardiologist wanted me to have a MRI after the 4.3cm reading, but even though I have insurance it was going to cost me about 2,000.00 since I would have to pay the entire amount until I reached my deductible and then pay 20% of the cost after that. I simply don't have the money and the payment schedule the hospital was willing to set up was going to add interest to the payment in the neighborhood of 20%. Me and my cardiologist discussed it and she agreed that we could wait on the MRI for now. I will be going back for another echo in 6 months and at that point we will discuss whether or not a MRI needs to be done regardless of my financial situation.
One more thing...echo measurements of the aortic root can vary quite a bit (especially when we are talking about differences in a few millimeters) depending on the tech doing it, they type of echo they are using, and what axis they are measuring the aortic root from.
According to the list of "normal" sizes that is on the bottom of my scan report...3.8 is at the largest end of Normal...so any bigger than that and you become "abnormal". They also take into account your body surface area and build etc. before declaing your aorta aneurysmal. I believe they also say 2 1/2 times your normal size is when its called an aneurysm.
Thank you for the info. I am having my aortic valve replaced and mitral valve repaired sometime in next couple of weeks. I meet with the surgeon next week to schedule and to discuss any other procedures he, and my cardiologist believe are needed.