ascending aortic aneurysm

[Lauberth]

Hello,

I got a AVR a year ago with an On-X mechanical valve. They also told me I have a moderately dilated ascending aorta, and will go for a re check and a couple months to see if its grown more, so they considered a whole year before checking for anymore dilation again. My question is do any of you have any experience with the same thing and do you guys know how fast does an aneurysm usually grow? My cardio at the Boston Children's Hospital where my AVR was performed said that even after AVR the dilation could still continue. Any inside on this will greatly appreciated.

Thank you all so much in advance!

 

[nightingale]

I had an AVR in 11/06. At that time my aorta was normal in size. 5 years after that I was told it had grown to 4 cm. A year and a half later it 4.5 cm, and it was decided I needed surgery due in part to the relatively fast growth. On the other hand, I have heard from many people who are in the low 4s and have been for many years without much change.

 

[AZ Don]

In general, thoracic aortic aneurysms grow at about 0.1 cm per year, but individual result can vary widely, and I've read separately that larger aneurysms tend to grow faster.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605304/

If you had a BAV, you should talk to your Dr. about Losartan. It has been shown in limited studies on patients with Marfan's to slow and possibly even reverse aneurysm growth. It has been suggested that the process may be similar for those with BAV and so these patients may see similar benefits. It's being studied now: http://clinicaltrials.gov/ct2/show/NCT01390181?term=losartan+bicuspid&rank=1

See also discussions of Losartan in this forum.

 

[clay_from_nj]

I have read that people with BAV have an increased risk of aortic aneurysm, but haven't been able to find any real numbers, such as what is the chance that a BAV patient will develop aneurysm, and at what age? Plainly, how concerned should I personally be about it? I did find this, with a little data: https://circ.ahajournals.org/content/119/6/880.full.

A study of prevalence by age quintile showed dilatation in 56% of those aged <30 years old, up to 88% of those aged >80 years old.

but​

Other studies have shown that age at presentation of aortic dilatation was significantly younger with BAV versus TAV (mean, 49 versus 61 to 64 years old).

Does this mean that after 49, with no sign of aneurysm, my risk will go down?

Also, they're talking about dilation in general, not how much or whether or not it leads to dissection. If I'm 80+ years old and my aorta is a little dilated, that will probably be the least of my worries.

BAV disease carries a 6.14% lifetime risk of aortic dissection, 9-fold higher than the risk in the general population.

6.14% doesn't sound like a great likelihood. Looks like I've got bigger worries: http://www.nsc.org/news_resources/injury_and_death_statistics/Documents/Injury_Facts_43.pdf

And if I'm getting an echo every year, though my chance of having aortic dilation is greater than the general public, I would suppose that early detection actually increases my chance of survival.

In a study of dissecting aortic aneurysms in patients aged <40 years old, 9 (24%) of the 38 cases were associated with BAV. From a US cardiovascular registry of dissecting aortic aneurysms, 11 (9%) of the 119 specimens had a BAV, and 5 of those patients were aged <30 years.

Looking at it that way, only 9% of dissecting anerysms had BAV, the odds don't sound too bad.

The five- and 10-year survival rates for those in the bicuspid aortic valve group were 97 percent and 96 percent, compared with 97 percent and 97 percent in the general population. (http://abcnews.go.com/Health/Healthday/story?id=5818636)

Okay, that makes me feel better.

PS - I don't have Marfan's, therefore the stuff related to that is totally irrelevant to me.