Aneurysm

Fred4 · Sep 14, 2005

See the interesting article in today?s Wall Street Journal, on the ?silver-lining? associated with ascending aortic aneurysms: very low arteriosclerosis or as I would say, hardening of the arteries. (page D4). Hard to appreciate, but a good thing.

I've been wrestling with a 4.8 cm aorta for three years and delighted to have found this site. It is very helpful in at least helping me more productively focus my many worries about this.

Fred

Karlynn · Sep 14, 2005

Welcome Fred. I'm glad you found us. Do you have a bicuspid aortic valve, or a regurgitating aortic valve as well? Or are you only dealing with the aneurysm?

Mary · Sep 14, 2005

Welcome Fred!
I see you live in St. Louis; we have several members from the St. Louis metro area. I'm in Cape, but I had my replacement at Missouri Baptist.
I'm curious, like Karlynn, to know if you have a valve problem in conjunction with your aneurysm?

Tom F. · Sep 14, 2005

The WSJ is not always the same from one region to another. I could not find it in my copy and I am in Chicago. But I did find it online, as follows:

"Aortic aneurysm associated with decreased incidence of atherosclerosis
New Haven, Conn.-Oddly enough, having an aneurysm in the ascending aorta is significantly associated with decreased incidence of atherosclerosis, according to a study by Yale School of Medicine researchers published this month in Chest.
An aortic aneurysm is a widening of the major artery leading from the heart that may rupture, causing hemorrhage, or may split into layers, jeopardizing blood flow to internal organs. When split into layers it is called "aortic dissection."

"This is a silver lining in the cloud of aneurysm disease," said John Elefteriades, M.D., section chief of cardiothoracic surgery in the Department of Surgery and senior author of the study.

He said the study was prompted by clinical observations that patients with aortic aneurysm and dissection-men and women, young and elderly-had a noteworthy absence of atherosclerosis. Most patients, Elefteriades said, begin showing the earliest signs of atherosclerosis in their 20s. "Surprisingly, the arteries of the patients with ascending aortic aneurysm looked like a baby's or a young child's," he said.

This study included 64 patients between 36 and 82 years of age with aortic aneurysm or dissection. The control group consisted of 86 trauma patients who had undergone computerized tomography of the chest. The lower prevalence of calcification in patients with ascending aortic aneurysm and dissection was independent of the major risk factors for heart disease-age, gender, high cholesterol, hypertension, diabetes and smoking history. In fact, the aneurysm patients appeared to be significantly protected despite a higher cholesterol level.

In earlier studies Elefteriades and his colleagues demonstrated the heritable nature of ascending aortic aneurysm and dissection. He said it is conceivable that the mutations inherent in aortic aneurysm also play a role in the atherosclerotic process.

"If patients with certain heritable aortic pathologies exhibit decreased systemic atherosclerosis, this finding would be important by virtue of providing new insights into the pathophysiology of the most common cause of death in the western world, heart and blood vessel disease due to atherosclerosis," he said. "

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Fred4 · Sep 14, 2005

Aneurysm

About the valve questions you asked--I don't think I have this complication. They've done repeat scans to determine aorta size, and an echocardiogram (sp) which generally was normal. The doctor said he was a little suspicious of the echo read on the valve, but saw nothing definitive. They tried to do a TEE, but (I am sorry to report) under the sedative I apparently became extremely uncooperative. Extremely. I have no memory of this. The cardiologist was reluctant to put me under for what he viewed as unnecessary reason, given his view of my stable history on this. I OTOH am an incessant worrier. My impression however is that when they do the aortic repair one usually ends up with a valve replacement.

Tom F. · Sep 14, 2005

Fred: "My impression however is that when they do the aortic repair one usually ends up with a valve replacement."

In Dec. of 2002 I had a David-V type valve sparring procedure done to correct an ascending aortic aneurysm My valve was normal, so it was not replaced. I am not sure exactly what your comment above means, but thus far when done by an experienced surgeon the valve sparing procedures are showing themselves to be very durable with a low re-operation rate. Make no mistake, no matter what you have done, even a mechanical, there is a chance that you will need another surgery for one reason or another. However, as for the belief that everyone with an aortic valve repair will eventually need replacement, well that is just not supported by the numbers.