Is an aneurysm common for people with a bicuspid valve?

[shah4u]

I had an aortic valve replacement surgery in 2017 and till now everything has been fine with regular INR home monitoring and checkups by the Cardiologist, but one thing has been noted that the ascending aorta's size has increased steadily over the years from 3.5cm in 2017 when I was operated to 4.3cm as of now. The surgeon says he will be monitoring it closely with CT till it reaches 5cm and then will only opt for any interventional surgery, and given my growth rate it looks fairly sure that another surgery is needed in the future. So I want to know whats the surgery is like and the success rate given I am already on blood thinner.

 

[Chuck C]

Hi.

Per your question:

Is an aneurysm common for people with a bicuspid valve?​

The answer is yes. aneurysm is very common with bicuspid valve. I am also BAV. When I had my surgery in 2021, they took care of my aneurysm at the time so that I would not have another OHS down the road. I now have a Dacron graft which has replaced my aortic root and ascending aorta.

It is too bad that they did not fix your aneurysm when they replaced your valve, but in that your aneurysm was 3.5cm at the time of your valve surgery, the guidelines do not call for valve replacement at that size.

So, mine is a little different from yours, in that both were taken care of at the same time, like many other members here. There are also many members who are in your situation, getting valve surgery initially and then needing another operation years later for an aortic aneurysm.

Your aortic aneurysm will be similar to your valve surgery, in that it is an OHS operation. They will cut out the aneurysm and replace that segment of your aorta with a dacron graft. At that time, depending on the location of your aneurysm, and other factors, they may also replace your valve with a new valve.

At a competent high volume hospital, this surgery has a very high success rate, as is also the case for valve surgery.

There are several members here who have been in your situation- valve surgery, then another OHS for their aneurysm repair. I'm sure that some of them will give you input on their experience.

The surgeon says he will be monitoring it closely with CT till it reaches 5cm

Good. It is important to closely monitor aneurysms and to get the repair when it reaches a certain threshold.

 

[shah4u]

Hi.

Per your question:

Is an aneurysm common for people with a bicuspid valve?​

The answer is yes. aneurysm is very common with bicuspid valve. I am also BAV. When I had my surgery in 2021, they took care of my aneurysm at the time so that I would not have another OHS down the road. I now have a Dacron graft which has replaced my aortic root and ascending aorta.

It is too bad that they did not fix your aneurysm when they replaced your valve, but in that your aneurysm was 3.5cm at the time of your valve surgery, the guidelines do not call for valve replacement at that size.

So, mine is a little different from yours, in that both were taken care of at the same time, like many other members here. There are also many members who are in your situation, getting valve surgery initially and then needing another operation years later for an aortic aneurysm.

Your aortic aneurysm will be similar to your valve surgery, in that it is an OHS operation. They will cut out the aneurysm and replace that segment of your aorta with a dacron graft. At that time, depending on the location of your aneurysm, and other factors, they may also replace your valve with a new valve.

At a competent high volume hospital, this surgery has a very high success rate, as is also the case for valve surgery.

There are several members here who have been in your situation- valve surgery, then another OHS for their aneurysm repair. I'm sure that some of them will give you input on their experience.



Good. It is important to closely monitor aneurysms and to get the repair when it reaches a certain threshold.

3cm to 3.5cm is the standard size that I had and the surgeon said the same thing when I asked why he didn't do both of them together that it was not needed at that time but now it is looking more likely that it will be needed in future, so monitoring the situation is the main thing I can think of. Also, I would like to know what's the efficacy of the DACRON graft since he mentioned the same graft to me for the aneurysm. The hospital I chose for the last surgery specializes in Cardiac surgery only with high volume and success that's why I chose it, also the doctor has prior working experience in Australia which makes it easier in my mind that he knows what he is doing. hoping for the best.

 

[SatoriFround]

As others have said, yes it is common in people with BAV. I haven't had surgery yet, but will be getting a valve replacement and aneurysm repair at the same time. I have one appointment with a surgeon next week and am waiting on my doctors network to transfer my testing records to a second surgeon so I can set up that appointment.

 

[Chuck C]

I would like to know what's the efficacy of the DACRON graft since he mentioned the same graft to me for the aneurysm

See link below to learn more about Dacron grafts:

"Dacron is so completely compatible with the body that rejection and calcification do not occur. With the passage of time the body deposits its own tissue into the Dacron graft. Today's modern Dacron grafts are strong, flexible and collagen impregnated, making them impervious to blood. The durability of these grafts exceeds that of the human life span."

https://www.cedars-sinai.org/health...rgical removal of some,of the human life span.

 

[SatoriFround]

See link below to learn more about Dacron grafts:

"Dacron is so completely compatible with the body that rejection and calcification do not occur. With the passage of time the body deposits its own tissue into the Dacron graft. Today's modern Dacron grafts are strong, flexible and collagen impregnated, making them impervious to blood. The durability of these grafts exceeds that of the human life span."

https://www.cedars-sinai.org/health-library/diseases-and-conditions/o/open-aortic-repairs.html#:~:text=The surgical removal of some,of the human life span.

Do they make valves out of this material? LOL

 

[pellicle]

Good morning

for what its worth I agree with everything said above, however I'm not sure if this is already well addressed so:

The surgeon says he will be monitoring it closely with CT till it reaches 5cm and then will only opt for any interventional surgery,

this is the usual approach.

Until that point awareness and monitoring is (in the main) all that's needed.

and given my growth rate it looks fairly sure that another surgery is needed in the future.

its a probability ... there are situations where after the valve is replaced it does not require surgery in the future. Some people explain it as being "supported and strengthened by the scar tissue in the area" (remember scar tissue is not just something on the surface of your skin, its all the way down and encompasses everything that was cut or injured inside (even the very stitching holes). I'm not sure if this "explanation" (of the scar tissue support) is correct or not.

So I want to know whats the surgery is like and the success rate given I am already on blood thinner.

being on blood thinners makes zero difference to the experience; simply because they will cease the blood thinners for the surgery and then re-establish you back on them after healing has proceeded the correct amount.

This is normal ... yes you're on blood thinners (a stupid name that I despise mot least because its wrong) for life but that is "general life" ... as with everything there are exceptions. When needed you simply go off them. Please read this (blog post of mine) in some detail, carefully and patiently for an example of why you may be taken off blood thinners. It is centered around my experience and this article:





I hope that you find that you don't need future surgery, but my advice is to live life normally and don't regard this as a Sword of Damocles but as simply you being aware that all sorts of stuff happens in life but you just happen to know about one of them now. I'd be surprised if you didn't know anyone who:

• had a serious accident
• contracted cancer
• became diabetic
• ...

Best Wishes