Ascending aortic aneurysm replacement

[Jason]

Hello all,

I previously posted about being readmitted to the hospital for A flutter, and while I was there the cardio on call ordered an echo. I am not sure what they were looking for with the echo when my heart was going crazy, but they did one. Anyhow...

The echo tech made an off-hand comment while running the test, and said "Oh, she really necked down your aorta". Of course, that had been bothering me off and on when I think about it, and I realized that I knew all about my valve but virtually nothing about the aorta graft. I called one of my surgeon's nurses and talked to her today about the outcome of the surgery. The graft that was inserted is a gel weave graft, 28 mm diameter, and it wasn't noted how long it was. The aortic root was saved, as we thought going into the surgery.

Now my question is, how does this compare to most people? I don't know if 28mm is small, big, in between, etc. I know that prior to the surgery my aorta had expanded to 5.4cm, so it was indeed reduced quite a bit. However, 5.4 cm was way too large, and his comment is still bothering me. Probably doesn't mean anything, but thought I would throw this out there for others to compare to.

Thnks

 

[Duff Man]

I might get a copy of the echo "film" and actually look at the post op aorta on disk to see what she means by "necked down". If you had a post-op ct scan, it'd probably be easier to look at. It takes a long time for me to understand what I'm looking at on an echo disk.

It could mean the proximal aorta is bigger than the normal sized graft, it could mean the graft is smaller than your normal sized aorta... or she could just be scaring you with unnecessary commentary.

I found a chart for carbomedics valves and their corresponding default sized graft... it seems that the valve's annulus diameter determines the diameter of the graft:

http://img109.imageshack.us/i/carbomedicsvalveandgraf.png

and the carbomedics valve catalog:

http://www.sorin-ushv.com/pdf/ICO_8...l_Valsalva_Ascending_Aortic_Prosthesis_Fl.pdf

 

[Jason]

Well, this makes some good sense as my valve is a 25mm and my graft is a 28mm, just like both of the catalogs you found show. The only difference is that mine isn't connected like these, as my aortic root was left intact as it wasn't expanding at all yet. I am betting on just an offhand comment by the tech, which the tech shouldn't have said. That being said, it is something that has been bothering me, so thanks for finding this source material.

 

[Bill B]

Deleted - I see you already understood the tech should not have made this comment.

 

[Bryan B]

Yes echo techs should not make comments. My cardios and surgeons even see things differently than the radiologist that reads them. For instance the radiologist read from a CT scan that my aortic dilation was 5.1cm at the root and 5.4cm at the ascending aorta. My surgeon read 5.4cm at root and 5.8cm at ascending aorta. After the surgery my surgeon said ascending aorta was actually 6.0cm when he did surgery (he didn't mention aortic root size). He also had to use a different valve than planned because the size of my aortic root was larger than he expected and the valve we had chosen didn't come in the size he needed (we were going to use Mosaic Freestyle with root), so now I have a dacron sleeve for my aortic root and ascending aorta. My only symptom post surgery is a pounding heart and my cardio (who I saw yesterday) thinks that will subside as my heart remodels. FYI...I had A-Flutter several months before surgery and had an ablation which has worked great...no A-Fib/Flutter since then and no medications for it.