Newbie ascending aorta aneurysm

[deancass2000]

I can definitely come miserate. "Fortunately", sounds weird saying that, when My aneurysm was discovered back in 2014 It was estimated to be 4.7 to 4.8 cm, my cardiologist wanted me to watch and wait and just don't lift anything heavy and all that and put me on blood pressure medication even though I never had high blood pressure etc. Seeing as to how big it was, my surgeon said I was on the cusp and he could warrant surgery if I wanted it. Of course I asked him if I waited, 5 to 10 years at most, did he think they would be any major surgical improvements. That or the obvious fear of a bad surgical outcome but I decided to get it over with. I lived for 11 months with the aneurysm and afterwards I have no restrictions at all. Can speak for anybody else but my surgery was in February 2015 and I barely think about it

wow, thats great to hear! glad you are doing so good so many years later. very encouraging! thank you

 

[cldlhd]

wow, thats great to hear! glad you are doing so good so many years later. very encouraging! thank you

Yeah it's funny how that works, it was 7 years ago but it feels like the other day. I'm hoping I get maybe another 50 out of it....

 

[cldlhd]

Well, you can get multiple opinions. I was on the 2x a year scan plan (alternating echo w/an MRI, no contrast) and then the 4x a year scan plan, as I was getting into the high 4s. Finally, my cardiologist told me to come back in three months and check it again. My valve was continuing to deteriorate but I felt fine, and I had been consulting for the prior two years with Dr. Svensson at Cleveland. Each time he said (via email) we should revisit in a year.

Finally, I said to my cardiologist - I need to get on with my life... and THIS time Svensson said - you should come in. I did and THIS time he said I should have surgery sooner rather than later.

The kicker - while my AA was just under 5, it was the valve's condition - and the risk that it would damage my heart - that forced the surgery. He specifically said that if the valve had been ok he wouldn't have pushed for the surgery at that time (two yrs ago.)

So, the watchful waiting.... I had limits on the amount I could lift - I think it was under 50 lbs. I say just get on with your life but make sure you stay with it and, if you are concerned, get a second opinion... maybe from a top center, which can do it virtually.

Best of luck with it.

Herb

Yeah, I think it's pretty common of an experience that surgeons are more eager to operate than cardiologists. My surgeon, Dr. Bavaria, thought going in was a good idea and my aneurysm was measuring 4.8 cm

 

[Duffey]

And i have done that. I have scheduled an appt for April 5th with a top surgeon at Missouri Baptist in St Louis. The first question the nurse asked me is why hasn’t your current cardiologist requested and echocardiogram? I said, now you know why i’m calling you guys. I just felt like my current cardiologist wasn’t doing enough.

And she said it was very important to mention my brother who died 17 yrs ago from an aorta aneurysm. She stressed that emphatically.

So i guess i’ll see what the surgeon has to say on April 5th

Do you mind sharing which cardio thoracic surgeon you’re seeing at Missouri Baptist? I had my avr performed there almost 17 years ago by Dr. Kouchoukos and wonder who has since taken his place.

 

[Dano64]

And i have done that. I have scheduled an appt for April 5th with a top surgeon at Missouri Baptist in St Louis. The first question the nurse asked me is why hasn’t your current cardiologist requested and echocardiogram? I said, now you know why i’m calling you guys. I just felt like my current cardiologist wasn’t doing enough.

And she said it was very important to mention my brother who died 17 yrs ago from an aorta aneurysm. She stressed that emphatically.

So i guess i’ll see what the surgeon has to say on April 5th

I had a similar experience. My cardiologist never advised me about any connection between BAV and ascending aortic aneurysm, and for years, he never had the echo tech look that high. He scared the bleep out of me in 2018 when they first discovered my aneurysm at 4.9 cm. Then I was referred to my surgeon, who calmly suggested we watch and wait. It stayed at 4.9 for 3 years until in grew to 5.2 by 11/21 and my surgeon was ready to roll. I felt very comfortable with my surgeon vs. my now retired cardiologist. Best wishes to you.

 

[DebW]

I was 62 when I was diagnosed with 5.7cm aortic root aneurysm and bicuspid valve. Surgery was October 31, 2017. Drs wanted to know when I was told I had a heart murmur. My answer - never. I did experience palpitations occasionally. In January 2017, my heart would "race" and not stop in a few moments, made breathing a little difficult. That's when I followed up with my doctor. It took an emergency room visit with an increased heart rate and extreme high blood pressure to get the ball rolling. Still waited months for surgery. Always afraid of a rupture.

I am an obese woman, who is so very grateful I get to spend time with my babies, and grand babies. The cardiologist I saw said he had never had a patient my age, with as advanced size aneurysm, that had successful outcome. I told him that was good. I like to be 1st once in a while! ❤

 

[deancass2000]

I was 62 when I was diagnosed with 5.7cm aortic root aneurysm and bicuspid valve. Surgery was October 31, 2017. Drs wanted to know when I was told I had a heart murmur. My answer - never. I did experience palpitations occasionally. In January 2017, my heart would "race" and not stop in a few moments, made breathing a little difficult. That's when I followed up with my doctor. It took an emergency room visit with an increased heart rate and extreme high blood pressure to get the ball rolling. Still waited months for surgery. Always afraid of a rupture.

I am an obese woman, who is so very grateful I get to spend time with my babies, and grand babies. The cardiologist I saw said he had never had a patient my age, with as advanced size aneurysm, that had successful outcome. I told him that was good. I like to be 1st once in a while! ❤

What a great story! I’m so glad you are able to enjoy your grandkids! I have two on the way! Thanks for your input. Here’s to many more years of enjoying them!

 

[deancass2000]

I had a similar experience. My cardiologist never advised me about any connection between BAV and ascending aortic aneurysm, and for years, he never had the echo tech look that high. He scared the bleep out of me in 2018 when they first discovered my aneurysm at 4.9 cm. Then I was referred to my surgeon, who calmly suggested we watch and wait. It stayed at 4.9 for 3 years until in grew to 5.2 by 11/21 and my surgeon was ready to roll. I felt very comfortable with my surgeon vs. my now retired cardiologist. Best wishes to you.

Wow, thats great! Kinda the same scenario im in. The surgeon’s office called this morning and already has setup tests i thought my cardiologist should have done. Thanks and best wishes to you as well.

 

[deancass2000]

Do you mind sharing which cardio thoracic surgeon you’re seeing at Missouri Baptist? I had my avr performed there almost 17 years ago by Dr. Kouchoukos and wonder who has since taken his place.

I sent you a private message with his info

 

[Keithl]

Yeah, I think it's pretty common of an experience that surgeons are more eager to operate than cardiologists. My surgeon, Dr. Bavaria, thought going in was a good idea and my aneurysm was measuring 4.8 cm

Actually my old Carido was pushing me more for surgery and every time I went to surgeon he said not yet.

 

[bizinsider]

I just want to add one other thing I learned in my journey - cardiologists, radiologists and surgeons "cut" the measurements differently. And a CT or MRI w/contrast is as close as they can go to perfection. In my case, the cardiologist always referred to the surgeon for the final decision and when the AA seemed perilously close to 5.0 the surgeon's measurement was more like 4.7-4.8.

 

[bizinsider]

And she said it was very important to mention my brother who died 17 yrs ago from an aorta aneurysm. She stressed that emphatically.

So i guess i’ll see what the surgeon has to say on April 5th

BTW, just seeing this.... sounds like you have a great cardiologist who is ON IT. Family history changed everything. Go into all of this with your head high, great attitude and treat it as a journey of life. We've all been there, done that and are here to say that the bark is worse than the bit. (Post-op drugs'll do that - you tend to forget the worst of it... or if you remember it, you remember it as not so bad."

You have a great group of folks here to cheer you on.

 

[deancass2000]

BTW, just seeing this.... sounds like you have a great cardiologist who is ON IT. Family history changed everything. Go into all of this with your head high, great attitude and treat it as a journey of life. We've all been there, done that and are here to say that the bark is worse than the bit. (Post-op drugs'll do that - you tend to forget the worst of it... or if you remember it, you remember it as not so bad."

You have a great group of folks here to cheer you on.

Lol, thanks for the positive vibes!
I go April first for a new CT then April 5th to the surgeon for consultation. Fingers crossed!

 

[carolinemc]

Actually my old Carido was pushing me more for surgery and every time I went to surgeon he said not yet.

Thank goodness you are able to say to the Cardio, bye. Many are with surgeons and use us as the money bank. But good the surgeon was on your side.

 

[deancass2000]

In rereading the responses i guess i really didn’t see how doctors mainly fix the ascending aorta. I’ve seen 2 different ways in my research, a stent or a dacron graft. My cardiologist told me the stent is becoming more common. What have people had done and was it your choice or the surgeons?

 

[Unicusp]

In rereading the responses i guess i really didn’t see how doctors mainly fix the ascending aorta. I’ve seen 2 different ways in my research, a stent or a dacron graft. My cardiologist told me the stent is becoming more common. What have people had done and was it your choice or the surgeons?

The only fix that I've seen for AA aneurysm is the dacron graft. They replace the fragile skin with it. A stent is usually used to open clogged arteries. Different application. I don't see how a stent would help here. I'm not aware if it is a new application. Unless you are talking about a totally different issue with the aorta. Need more detail that you heard from your cardiologist.

 

[deancass2000]

The only fix that I've seen for AA aneurysm is the dacron graft. They replace the fragile skin with it. A stent is usually used to open clogged arteries. Different application. I don't see how a stent would help here. I'm not aware if it is a new application. Unless you are talking about a totally different issue with the aorta. Need more detail that you heard from your cardiologist.

Im talking about the same issue, ascending aorta aneurysm. And yes, there are stents made for inserting into the ascending aorta to strengthen the aneurysm so it wont dissect. Youtube has videos showing it and again, my cardiologist said it was becoming more common to fix the AA aneurysms.

https://youtube.com/shorts/3MjVRjdEvE4?feature=share

 

[Unicusp]

Im talking about the same issue, ascending aorta aneurysm. And yes, there are stents made for inserting into the ascending aorta to strengthen the aneurysm so it wont dissect. Youtube has videos showing it and again, my cardiologist said it was becoming more common to fix the AA aneurysms.

https://youtube.com/shorts/3MjVRjdEvE4?feature=share

I just did some quick searches and they all referred to abdominal not ascending. Personally, I wouldn't do it and would go with the proven tried and true Dupont Dacron tube. It will outlast you. Can the same be said about a stent? Doubtful.
Looking back at your first post, it looks like you may have many years to watch and wait, and allow technology to accumulate more experience and data with stents and other new stuff.
So, that's good. No rush to make any decisions.

 

[deancass2000]

I just did some quick searches and they all referred to abdominal not ascending. Personally, I wouldn't do it and would go with the proven tried and true Dupont Dacron tube. It will outlast you. Can the same be said about a stent? Doubtful.
Looking back at your first post, it looks like you may have many years to watch and wait, and allow technology to accumulate more experience and data with stents and other new stuff.
So, that's good. No rush to make any decisions.

I think you’re misunderstanding my question. I wasn’t making a case for either one, I asked what people have had done and whether their surgeon offered a choice. It’s almost like you think I am supporting a stent over the dacron graft. I am not. I merely asked the question to see what others have had done to repair an ascending aorta aneurysm.

 

[pellicle]

I asked what people have had done and whether their surgeon offered a choice.

mine did ... he described the benefits of either and would give me what I sought. I was pretty clear (like Bulgarian Crystal) that I'd take what I took