Newbie ascending aorta aneurysm

[Croooser]

deancass,

I too, experienced nagging anxiety over the years regarding an ascending aortic aneurysm but mine was >4.7cm. With a deteriorating valve, one usually gets some early warning in the form of symptoms, but not much with the aneurysm until it fails.

A couple of famous anecdotes: John Ritter, the American actor, died when an undiagnosed aortic aneurysm failed.

OTOH, Jamie Dimon, CEO of Chase, barely made it to the hospital in time.

FWIW, I was first diagnosed at 4.7cm in 2003 along with a 1.8 AVA. My test results at two different cardio clinics varied over the years from 4.7 to 5.0. I was told that those kind of results varying by .1 from one test to the next were within the margin of error for contrast dye CT scans. Note that mine only grew by .2cm over 18years - YMMV. By 2021 my aortic valve had measured severe at .9 and it was time for the OR for that and the aneurysm was fixed at the same time. My echo 4 months after surgery had the ascending aorta at<3.7.

As noted in the data shared with you above, at 4.2, the risk is considered to be quite low. In addition, I believe that for most of us, until measured at least 5.0, the risk of surgery is greater than the risk of the aneurysm failing unless there is also a valve issue or some other mitigating factor.

Makes me feel like maybe I jumped the gun , I had my surgery when the scans said my ascending aorta was 4.8cm but when measured after removal it was 4.99cm. Maybe this is a thread hijack , if so I apologize, but post surgerical repair with a Dacron graft my CT scans said it was 3.4cm (6 yrs ago) but my latest scan last month said it was 4.0cm which seems both odd and concerning a bit.

Chuck, maybe time for another test at 6 months instead of waiting a year? My cardio says that I should be one and done on the Dacron graft but at 71 yo my life expectancy is shorter than many on this forum.

 

[cldlhd]

time will tell mate ... all we can do is continue living (as opposed to being paralysed by fears and concerns and find out over time.

Best wishes

Thanks, I did a little googling and there was a report from the NCBI that said gelseal Dacron grafts can grow 3.23% ( pretty specific) for the first 5 years then apparently stop? So numbers wise I guess that adds up. I haven't really heard much out here about people having an issue with a graft growing to the point where it needs replacement. The conclusion of the report is there were no issues regarding the size growth. I also thought it was interesting that it grows 10% immediately upon "installation" . So I guess I'll talk to the surgeon about it. I'm due for a follow-up, actually overdo but you know how it goes, and see what he says. Thanks for the wishes.

 

[cldlhd]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329298/Now this may be a bit dim on my end but I'm not 100% sure that's the same type of graft I received. I'll have to check, I know it was a Dacron graft but that's about all.

 

[deancass2000]

deancass,

I too, experienced nagging anxiety over the years regarding an ascending aortic aneurysm but mine was >4.7cm. With a deteriorating valve, one usually gets some early warning in the form of symptoms, but not much with the aneurysm until it fails.

A couple of famous anecdotes: John Ritter, the American actor, died when an undiagnosed aortic aneurysm failed.

OTOH, Jamie Dimon, CEO of Chase, barely made it to the hospital in time.

FWIW, I was first diagnosed at 4.7cm in 2003 along with a 1.8 AVA. My test results at two different cardio clinics varied over the years from 4.7 to 5.0. I was told that those kind of results varying by .1 from one test to the next were within the margin of error for contrast dye CT scans. Note that mine only grew by .2cm over 18years - YMMV. By 2021 my aortic valve had measured severe at .9 and it was time for the OR for that and the aneurysm was fixed at the same time. My echo 4 months after surgery had the ascending aorta at<3.7.

As noted in the data shared with you above, at 4.2, the risk is considered to be quite low. In addition, I believe that for most of us, until measured at least 5.0, the risk of surgery is greater than the risk of the aneurysm failing unless there is also a valve issue or some other mitigating factor.



Chuck, maybe time for another test at 6 months instead of waiting a year? My cardio says that I should be one and done on the Dacron graft but at 71 yo my life expectancy is shorter than many on this forum.

deancass,

I too, experienced nagging anxiety over the years regarding an ascending aortic aneurysm but mine was >4.7cm. With a deteriorating valve, one usually gets some early warning in the form of symptoms, but not much with the aneurysm until it fails.

A couple of famous anecdotes: John Ritter, the American actor, died when an undiagnosed aortic aneurysm failed.

OTOH, Jamie Dimon, CEO of Chase, barely made it to the hospital in time.

FWIW, I was first diagnosed at 4.7cm in 2003 along with a 1.8 AVA. My test results at two different cardio clinics varied over the years from 4.7 to 5.0. I was told that those kind of results varying by .1 from one test to the next were within the margin of error for contrast dye CT scans. Note that mine only grew by .2cm over 18years - YMMV. By 2021 my aortic valve had measured severe at .9 and it was time for the OR for that and the aneurysm was fixed at the same time. My echo 4 months after surgery had the ascending aorta at<3.7.

As noted in the data shared with you above, at 4.2, the risk is considered to be quite low. In addition, I believe that for most of us, until measured at least 5.0, the risk of surgery is greater than the risk of the aneurysm failing unless there is also a valve issue or some other mitigating factor.

Thanks for the input. Im hearing this more and more as time goes by. My biggest worry is just not knowing what is too much?! The surgeon said, “Don’t strain yourself”. Well what exactly does that mean! Straining like on the toilet? Straining like lifting something extremely heavy?

 

[pellicle]

Hi

My biggest worry is just not knowing what is too much?!

given the stats and decades of dealing with this I'd say it goes like this:

• its not a piece of tissue prone to ripping unexpectedly for no reason
• you are (I hope) undergoing regular checks looking for growth (meaning indicators of increased chances of a rupture)
• if you begin some exercise routing you wish to do and then see if there is growth you will get some idea

The truth is much is unknown, but we do know some things which should be avoided (for example lifting with straining and holding your breath, using the biggest muscle groups (like your quads) with straining and holding your breath is probably the best example of the worst you can do.

In my own experience cardiovascular training but not pushing your limits was encouraged. Walking, cycling, keeping your HR well under you Max but into the training zone.

I encourage you to discuss this with your cardiologist.

Best Wishes

 

[deancass2000]

Hi


given the stats and decades of dealing with this I'd say it goes like this:

• its not a piece of tissue prone to ripping unexpectedly for no reason
• you are (I hope) undergoing regular checks looking for growth (meaning indicators of increased chances of a rupture)
• if you begin some exercise routing you wish to do and then see if there is growth you will get some idea

The truth is much is unknown, but we do know some things which should be avoided (for example lifting with straining and holding your breath, using the biggest muscle groups (like your quads) with straining and holding your breath is probably the best example of the worst you can do.

In my own experience cardiovascular training but not pushing your limits was encouraged. Walking, cycling, keeping your HR well under you Max but into the training zone.

I encourage you to discuss this with your cardiologist.

Best Wishes

Im not sure if you are replying without reading my previous posts? But yes, i posted i just went to the surgeon and had a cta scan and the size has not increased. Im on a regular review schedule to monitor the size. Im also already discussing the whole process with my cardiologist, previously posted in the start of this thread.

 

[pellicle]

m not sure if you are replying without reading my previous posts? But yes, i posted i just went to the surgeon and had a cta scan and the size has not increased.

equally I'm not sure if you're actually recalling that I have replied to your posts or if you're just ignoring what doesn't fit your idea.

what is it you'd like to hear?

you asked exactly:

”. Well what exactly does that mean! Straining like on the toilet? Straining like lifting something extremely heavy?

and I answered pretty exactly ...

if you've never lifted anything ever in your life than perhaps I can understand that you have no experience with straining other than on the can.

 

[deancass2000]

equally I'm not sure if you're actually recalling that I have replied to your posts or if you're just ignoring what doesn't fit your idea.

what is it you'd like to hear?

you asked exactly:


and I answered pretty exactly ...

if you've never lifted anything ever in your life than perhaps I can understand that you have no experience with straining other than on the can.

How about this. Just dont reply anymore.
It’s obvious you are just wanting to argue rather than help and to also just be a **** about it. You got all bent out of shape on an earlier post because i didn’t say thank you. Well, you’re replies aren’t something to thank you for, so please just stop replying if you would. I didn’t post my original questions for someone like you to get their ego stroked. All other replies have been extremely helpful, except yours. You’re a jerk, so just stop already.

 

[pellicle]

You’re a jerk

Right

 

[Daniel758]

How about this. Just dont reply anymore.
It’s obvious you are just wanting to argue rather than help and to also just be a **** about it. You got all bent out of shape on an earlier post because i didn’t say thank you. Well, you’re replies aren’t something to thank you for, so please just stop replying if you would. I didn’t post my original questions for someone like you to get their ego stroked. All other replies have been extremely helpful, except yours. You’re a jerk, so just stop already.

deancass2000, you're spot on.

Pellicle is a head case and does need to have his ego stroked or he goes off. I've been following this forum for 4-5 years now and I have seen this play out over and over and over again. His 9,744 posts say all that needs to be said here.

It's unfortunate, too, as I believe this forum has a lot to offer but it is limited by Pellicle and his small group of posters belittling poster after poster to inflate themselves.

I'm surprised the group that hosts this forum, if they want to increase traffic and ad revenue to keep it afloat, do not see this and step in.

 

[deancass2000]

deancass2000, you're spot on.

Pellicle is a head case and does need to have his ego stroked or he goes off. I've been following this forum for 4-5 years now and I have seen this play out over and over and over again. His 9,744 posts say all that needs to be said here.

It's unfortunate, too, as I believe this forum has a lot to offer but it is limited by Pellicle and his small group of posters belittling poster after poster to inflate themselves.

I'm surprised the group that hosts this forum, if they want to increase traffic and ad revenue to keep it afloat, do not see this and step in.

Thank you for validating my suspicions about him. I was reserved at first but then his responses just became ridiculous. I agree with you, this forum is great and the responses and feedback from everyone have answered a ton of my questions and put my mind to ease on a lot of what i was worried about. Im glad i found this forum and greatly appreciate all the replies. Thank you and everyone else.

 

[Captain Cavemen]

Hi deancass2000 bit of a lurker hear as still under the cardiologist with surgery expected soon for AAA and BAV in fact I see surgeon again next week. In answer to one of your posts yes Ascending Aortic Aneurysms can be stented but the tech is new and limited please follow link (Nexus stent | Royal Brompton & Harefield Hospitals Specialist Care (rbhh-specialistcare.co.uk) this technology has been expanded no pun intended to incorporate root and AAA with excellent results but only on a limited number of patients. Additionally and an avenue worth considering and one I may be measured up for next week is a Ross PEARS procedure again see link (Improving heart valve surgery for young adults | Royal Brompton & Harefield Hospitals Specialist Care (rbhh-specialistcare.co.uk) ). This aims to reduce the known aortic root dilation that can occur with the Ross procedure but this can also be achieved using other techniques to essentially reinforce the root during the procedure and this is universally done now as standard practice. I know in certain areas of this forum the Ross Procedure is frowned upon but in terms of medical opinion it can offer an excellent solution again see link from one of the world experts on the subject ()

All the best.

 

[pellicle]

Hey Captain

... but in terms of medical opinion it can

... also get a mixed review, so its not just me. Its only a selection of surgeons who promote it, ask them and they'll tout its benefits.

Like so many things it depends on who you ask. If it was unambiguous then there wouldn't as much be room for divergent opinions.

Here is an experience from one of the members here:
https://www.valvereplacement.org/th...edure-and-life-expectancy.887753/#post-900741
Best Wishes