Dilated Aortic Root

[kevin21]

Anyone have or had a dilated aortic root in addition to their AVR or other?

I don't have Marfan's so it is hard to research it in a Non-marfan setting.

I guess it is kind of like and anyurism (sp) or sorts. I guess that they can replace it or put a sleeve around it to help it.

Mine is at 4.2cm and normal is from 1.9-3.8 cm. so it isn't too out of wack but they noted "Dilated aortic root" along with "Moderate to severe aortic regurgitation" on the same line in my echo report.

Help.

(sometimes it just gets better and better)

 

[Tom F.]

In 2002 I was told that I had an aneurysm of the ascending aorta, which is essentially the same as you describe, except mine was on the ascending aorta, yours is in the root. My aorta had dilated to appx. 5cm., which is time to get it fixed. My aortic valve was essentially normal, only somewhat pulled out of shape by the aneurysm. The textbook fix for this would have been a dacron replacement for the damaged part of the aorta, and a new valve. Increasingly, at major heart center hospitals docs try to fix the aortic valve so as to avoide replacement. In the end that is what happened to me, I had a valve sparing surgery, still have the valve, and it works just fine now.

 

[kevin21]

In 2002 I was told that I had an aneurysm of the ascending aorta, which is essentially the same as you describe, except mine was on the ascending aorta, yours is in the root. My aorta had dilated to appx. 5cm., which is time to get it fixed. My aortic valve was essentially normal, only somewhat pulled out of shape by the aneurysm. The textbook fix for this would have been a dacron replacement for the damaged part of the aorta, and a new valve. Increasingly, at major heart center hospitals docs try to fix the aortic valve so as to avoide replacement. In the end that is what happened to me, I had a valve sparing surgery, still have the valve, and it works just fine now.

Glad to hear that!!

I think my root growth is due to the leaky valve, it came first (valve). I was searching and found that typically the root grows to accomadate a leaky valve. Hopefully they won't have to do much to it, maybe a new valve will ease the pressure and allow it to stop dilating. I'm thinking they might have to "wrap" it with a dacron sleeve to keep it in check. Not sure till I talk to surgeon on the 28th.

I was feeling more confortable about the valve surgery till I read about the root. Now I'm a little more scared! I'm stressing out about it again and it is consuming my free time. Going to sleep is a chore.

 

[kevin21]

This stinks, I just want to be around for my unborn kid.

This will be my 4th time on the heart lung machine, I had to go on it 2 times when I was 10 because they didn't communicate with the Cardio and the surgeon had to go back in and fix the stenosis (should have sued them, how could you not tell the surgeon something critical).

I just don't want to go out on the damn table. I'd rather bite it in a airplane wreck or something else.... (Sorry for the poor attitude).

And, to top it off, thinking about it and researching it surely doesn't help your "symptoms." It makes you think you have every symptom under the sun and even "phantom" chest pains etc...

 

[jenny]

I know how you must feel Kevin. But hang in there and you keep on top of your doctors . I never just believe them anymore. I try to do as much research as I can.......although, gee, sometimes I do get to many symptoms to my heart as I research information I need. I guess we all go through life knowing that it is a bummer at times. Hang in there though , I am sure there will be a rainbow of some sort for you. I hope so, Kevin........Jenny

 

[Tom F.]

Kevin, don't stress, don't stress or let it all get to you. You have the internet, a great place to search and learn. Get on google and do key word searches and in time you will know as much as some docs know ! But do not let this get to you. I learned in the Marines, God doesn't send you any more pain than you can handle. So just take a deep breath, and be cool.

 

[Mike From Michigan]

I ended up being diagnosed with a dilated ascending aorta of 5.5 cm just 2 months before AVR surgery during a MRI. Prior to that, it was NEVER detected in any test. In fact, that dilation was one big reason I immediately wanted the surgery - I didn't want to suffer the same fate as John Ritter (aortic dissection).

 

[kevin21]

Mike,

Did your root enlarge due to the valve? Is replacing it that big of a deal? I mean is it that much more problematic or etc than just the valve? (I know it is a big deal!)

Is the root different than the ascending or descending? Let me search while you guys give some opinions!! LOL!!

I'n not sure if being dumb to the whole thing is better or being informed? I guess being informed so you can watch yourself and the Dr's. I'm definatly taking the wife along to surgery and recovery so she can question things and write down the stuff they do. I want to make sure the don't foul up. I once got the wrong meds at Walgreens so I know how things happen.

 

[Granbonny]

Hi Kevin

Hi Kevin

I noticed that you had joined VR. in Dec. 2002....so I went to your User ID and clicked on all threads started by Kevin..You asked some good questions and got many good answers...You admitted you only came on here (VR) after a doctor's appointment. Big gaps in your posts. Please go back and read all of your threads...Then, when you see your surgeon on the 28th..next week..you will be able to ask him..what all is involved?Sounds like you will be having VR surgery sometime?.......I'm sure he will tell you..what all he will do when he opens you up..May as well fix it all..You don't want another VR. surgery since you have had 2 before..I read some of your concerns on other posts. The ticking..New Mech valves..you hardly hear them..The coumadin..I have been on it for over 2 years and NO problems..It will be your decision to how much rough-stuff you will want to do. Just be careful..Wear a helmet..if you do anything that might make you fall and hit your head. 6 weeks after surgery..you will start feeling like your old self again..and all these worries will be gone... You wil need someone home with you the first 2 weeks...Will not be able to drive yourself to Post surgery appointments, ect...Food will taste yucky.You will need a good recliner for naps..a lot of naps and a little walking the first 2 weeks...Let us know what your surgeon says next Wed. We will be here for you. Bonnie

 

[Granbonny]

Kevin

Kevin

I just looked at my Operative Procedure...AVR/ROOT/ 23 mm St. Jude valved conduit..so I guess they did something with my root? Still the same recovery..Was out from the time I said goodbye to my family (ON Happy shot Until I awoke in private room..Late the following day..Never remembered my being on any tubes..Just got up out of bed and started walking dragging my I.V. with me...( I think it had Happy Drugs in it, too} No pain..Bonnie

 

[kevin21]

Thank you all!!

 

[Susan BAV]

Hi Kevin - I think that an enlarged aorta is not unusual with a bicuspid valve.

Hope all goes well for you.

 

[tobagotwo]

Believe it or not, this is a common enough problem that there are off-the-shelf parts for replacements. Be aware that you definitely have many choices other than mechanical valves, as well.

Tissue offerings from Medtronics include Freestyle models for root-and-valve replacements. The Freestyle incorporates the same life-extending technologies as they use on their Mosaic valve.

To view: http://www.medtronics.com/cardsurgery/products/free_index.html

Once you're there, clicking on the blue text will bring up more information.

Edwards Scientific has the Edwards Prima Plus Stentless Bioprosthesis. They also use their own new life-extending processes in manufacturing it:

http://www.edwards.com/MedicalProfe...BA7-C9B8-4BA1-87E7-704BAF356F25&transferBack=

Once you're there, you will have to look further down the page to find the model.

There are also homografts that include the root.

Best wishes,

 

[Sir Reel]

I wouldn't worry too much about your aortic root because you can't do anything about it and it isn't likely to have much, if any, impact.

I had my aortic root replaced (Dacron) at the same time my aortic valve was replaced (bovine). While it obviously complicates things because additional surgery and another joint is involved, neither my surgeon nor my cardiologist have indicated that it has any material impact on me or my surgery, recovery, etc. My valve was leaking substantially before the operation, which in turn caused the root aneurism.

I was quite active before the operation ( I didn't even know I had a problem!) and have remained so from shortly after the surgery througn now (2 1/2 years later), playing tennis and riding road and mountain bikes extensively. The cardiologist placed no limits on me and the surgeon placed no limits except for avoiding lifting more than 75 lbs. The weight lifting limit is because lifting heavier weights increases your blood pressure and the surgeon said there is a division of opinion regarding whether it could cause the suture areas to work loose. I follow his advice. He wasn't concerned with an occasional increased exertion. He said I could train for and run marathons if I wanted. I push my heart a fair amount riding my bike (frequently averaging 80-85% of maximum heart rate and ramping up higher on hills).

Assuming your surgery goes well, you should be fine afterwards and the root shouldn't complicate your recovery or your life.

Good luck!

 

[kevin21]

Thanks Sir, reel LOL

I'm not so worried about it that much. I'm seeing a surgeon tomorrow to see what he thinks!! Big fun!! (wait, not really

 

[dano]

dilated root

dilated root

I had a dilated ascending aorta which began at the root and went up almost to the arch. That was my first surgery in 2001. I had a leaking valve that we tracked for 10+ years and also tracked the aneurysm. When it got to be over 5.5 cm, they told me it was time. The leaking didn't get a whole lot worse during that time. During the discussions with the surgeon, the plan was to replace the aneursym with a dacron sleeve and evaluate the valve to see if it could remain. He decided that it had stretched too far to take a chance. We had decided on a homograft, if he had to replace it and that comes with a piece of the root. Not sure if it would be enough to replace the anuersym in your case. If not, I think I'd opt for letting them deal with it now since you won't know how long it will be before it gets past the recommended surgery level. In my case, I think it did add some time to the surgery and I think they had to do the deep freeze because of the time to do the repair. But, I think that had more to do with the length of aorta they were replacing in my case. I thought everything was going well, but on a follow-up checkup a year or so later, they told me the new valve was functioning correctly, but was leaking. So, I had to have another valve replacement in 2003 (the replacement had developed holes in the leaves). However, the surgeon was able to leave the root from the homograft and just replace the valve. I decided to go mechanical at that point, and I will say that I can hear it clicking. I've not had any problems from the coumadin, but I'm not out trying to develop cuts either. I was pleasantly surprised at the recovery for both surgeries. Not that it was anywhere close to a piece of cake, but it wasn't as bad as I imagined. I must have some bad plumbling as I still have a descending and abdominal anuersym to deal with at some point. I would agree that you can find a lot of alarming information by searching through the net, but I do believe that it helps you understand what is going to occur. Just maintain a positive mindset and be grateful that we tend to treat this as quasi-common surgery (we know it's not). I did find the first few nights at home required sleeping in a recliner at an angled position as that was a lot easier to get up and down than laying flat on a bed.