My Dad has the same condition as me

[pekster11]

In early 2021 just a couple of months before my heart surgery my Dad caught a nasty bout of covid and had to spend time in hospital. Whilst there he had a scan of his lungs which incidentally picked up an ascending aortic aneurysm. The diameter was 5.4cm , and in the 2 years since it hasn't grown. However recent scans have shown that his aortic valve , like mine, is bicuspid.
My Dad is due to meet with the cardiac consultant in a few weeks to discuss options, although I think they're sizing him up for surgery.

I'm guessing his aortic valve can't be severely calcified and the level of stenosis is likely to be mild? Can a bicuspid aortic valve remain in decent enough condition to never need replacing?
He is nearly 78 and has no symptoms

I'm actually far more worried than I was for my own surgery, as he's 30 years older than I was

 

[pellicle]

Hey mate

I totally get why you put it that way, but I'm going to turn that around and say (causality direction) you inherited your BAV and associated connective disease from your dad.



either way I think that

I'm guessing his aortic valve can't be severely calcified and the level of stenosis is likely to be mild?

better not to guess and actually get it measured

Can a bicuspid aortic valve remain in decent enough condition to never need replacing?

at his age, certainly. Frankly I think that this is exactly the case where the old adage of the balance of the risks of sugery need to be weighted against the benefits. (more so than for us younger folks)

I'm going to say imaging and measurements are where you should go next and monitor at 3 months

He is nearly 78 and has no symptoms

suggesting the valve is probably OK and its just a matter of taking care with observation of the aneurysm. Which is in the danger threshold zone

This is the Australian guidelines, but I don't expect the UK to be too different.
https://www.anzsvs.org.au/patient-information/aortic-aneurysm-screening/

Large aneurysms are more likely to rupture but two major studies have recently shown, that for small AAAs less than 55mm (5.5cms) in diameter, the risk of rupture is low at approximately 1% per year (1 in 100). ...​

The development of a screening programe for AAAs which would detect aneurysms at an early stage (<5.5cms) when they are safe to monitor might avoid rupture in the majority of patients by giving these patients the opportunity of planned surgery to repair their aneurysm. Patients who smoke, who have high blood pressure or other vascular diseases such as cardiac or peripheral vascular disease are at increased risk of aneurysms. ​

...We now know from 2 major studies comparing early treatment with monitoring for small AAAs (<5.5cms) that it is safe to avoid operation until the aneurysm has expanded to 5.5cms unless it is rapidly expanding or becomes symptomatic.​

...If an aortic aneurysm is identified, the next step will depend on the size of the aneurysm. Patients with AAAs less than 4cms in diameter would require scans at 2-5 year intervals. For aneurysms from 4-4.4cms scans would be annually. For aneurysms of 4.5-4.9cms scans would be at 6 monthly intervals. For AAAs 5-5.4cms scans at 3 monthly intervals are needed. Some authorities advocate 3 monthly scans once the aneurysm reaches 4.5cms. Once an aneurysm has reached 5.5cms consideration should be given to treating the aneurysm and this will be appropriate in most patients​

HTH

Best Wishes

 

[Chuck C]

Sorry to hear about your dad's condition.

I'm guessing his aortic valve can't be severely calcified and the level of stenosis is likely to be mild? Can a bicuspid aortic valve remain in decent enough condition to never need replacing?

The answer is yes, some people with BAV never need surgery. Hopefully you're right and it is just mild. But, the imagery will give you good info soon enough.

Interesting that they've known about his aneurysm for 2 years and just found out now about his BAV. Glad that they found it, but just strange that they didn't look for it in previous echos, as BAV is commonly linked with aneurysm.

Best of luck and please keep us posted with their findings regarding severity.

 

[pekster11]

thanks for that guys
Yes I'll ask Dad to make sure he finds out the severity of the stenosis

I agree that surgery may not be the best course of action in this case given his age. The severity of the stenosis will be the deciding factor I think

 

[pellicle]

The severity of the stenosis will be the deciding factor I think

I agree, I expect also it will be.

The NHS will do all the stuff that's needed, so that's a positive thing.

Fingers crossed that he can just keep going as he has been. If he's not doing heavy lifting he may well be fine.

I know its a shock to find out, but if he's otherwise healthy then that's a plus IMO.

Best Wishes