Should I fix my slight Arch aneurysm!

[mikekass]

Hi,

I have an AR+AS bicuspid AV, and my cardio DR at Stanford had told me that I also have Ascending Aorta aneurysm (currently 4.3 cm). Based on my research on internet, all I have been reading is that when you have BAV it is caused by a tissue disorder that in most patients it also causes AAA. But when my surgeon at Stanford Dr Craig Miller (who is supposed to be expert on aneurysm) looked at my CT scan, he disagreed with my Cardio and told me that I also have some Aneurysm in the Arch. He told me if I do not fix it now, in the best case, I need to do another operation in 4-5years to fix it. But I am wondering if they fix my BAV why the Arch aneurysm would get worst. Any one has any feedback. I have read fixing the Arch Aneurysm is kind of risky. But my doctor has told me and another patient with exact same procedure that he has done thousand of these and he is telling me the total risk of mortality when he does all these three procedure is 1%. This is much smaller that I have read (I have read upto 5%). Any feedback is appreciated.

Thanks,
Mike Kass
AVR + Aneurysm fix
Surgery July-14

 

[Kate]

Hello again, Mike!
My aneurysm was plain old ascending aortic, so I don't know much about risks associated with the aortic arch. However, I can tell you that fixing your valve problem will not slow it's growth because, according to the most recent research, it is not the valve that caused it in the first place. The old theory claimed that the force of blood being ejected from the malformed valve somehow weakened the aorta's wall and resulted in the aneursym. However, the new theory is that the aneurysm is caused by underlying connective tissue weakness within the walls of the aorta itself and grows independent of what is happening with your valve. Since you are able to go to an experienced surgeon in a top-notch hospital, I'd get it corrected now if I were you. You don't want to be having surgery again in only 4 or 5 years and, as Ross and others can testify, aneurysms have been known to dissect at this size or smaller. Take care, Kate

 

[Ross]

I would certainly get a second opinion on that! If you have an expert aortic person working on you, I cannot see them exposing you to another surgery. I'm almost positive they can do both at the same time, though mine was not at the arch either, but just above the valve.

 

[JohnnyV_46]

I think its like going to the parts house for your car..they just need a different hose and it already has that bend made into it.

 

[temp69]

I say go for it.

I say go for it.

Me NOT doctor, but I would say go ahead and have all the work done you can now, so you won't have to re-op. Good luck! I've been told that they go in and see things and repair and/or replace as needed, which makes all the sense in the world. GOOD LUCK!

 

[Ozmercy]

2nd opinoin is good

2nd opinoin is good

I think you should get a 2nd opinion. Most doctors support your doing this as well. I know that the mortality rate is much lower now than in many of the older web sites. Also if you are going to a hospital that specializes in these procedures you will find their rates are much lower. Cedars recently did a study regarding aortic aneurysm repair surgeries and they only lost one person in 2 years, but that persons death was not realted to the surgery but from some other complication with their health. I will try to find those statistics from that study tomorrow if I have time. I believe it is one their website. Good luck