The Great Aneurysm Repair Timing Debate

[jjay32]

I'm not sure if I'm sick to my stomach because of the taquitos I just ate or because of the echo results from last week. I think the nurse said it's .4 cm bigger since like 8 months ago (she was totally evasive) but I have a follow up appt with the doc on Friday. Soooo bummed.

Anyone know the recommended guidelines for elective surgery when considering aneurysm growth rate? Seems like I read >.5cm a year is go time.

Your right, >.5cm a year is a strong indicator of go time. Normal average growth is about .1cm a year. My next round of echo and ct scans are in about 7 months.

Jjay

 

[MissMelis]

Hi all,

I hear you on the timing debate. I have an aortic root aneurysm last measured at 4.8 a year ago, after it had grown 0.8 cm over the course of 6 months. I am now awaiting an MRI on June 1. If it's gone over 5.0 I will push for surgery.
I know that my surgeon has stated that his "max size" is 5.0 cm, but my cardiologist is more like 5.5 cm...
So, I know it's kind of a risk vs. reward thing, but if they can't give you any good reason why you should wait for surgery, then what's the deal?

So to answer Duffman's question, from all the research I have read, 5.0 cm is sort of the accepted guideline for ascending/aortic root aneurysms, I think descending have a bigger max size.

Abbanabba - I think that the average growth of an aneurysm is supposed to be somewhere around .1 or .2 cm/year, depending on what you read. There's just no way of knowing - so as long as they are keeping an eye on it and there's no change, you should be good for a while yet - I hope so anyway!

Yolanda - did your husband's aneurysm appear as a result of the Ross procedure? There's a few of us on the forum for which this is the case.

Aaron - I hope they take care of you and you get it done so you can stop worrying. The waiting and not knowing is terrible!

Take care
Melissa

 

[Ross]

I know that my surgeon has stated that his "max size" is 5.0 cm, but my cardiologist is more like 5.5 cm...

Listen to the surgeon! He wants to fix you before damage occurs. Cardiologists are notorious for wanting to wait for it to start to occur.

 

[ccummins]

Wow, my experience was completely different. I hit 5 cm and they suggested to schedule surgery when possible. I am with the others in thinking that heck yeah, get the aneurysm taken care of! Surgery sucks but it is better then what could happen ... It seems my cardiac team is a bit different then others. My aneurysm was of far greater concern then my BAV. As a matter of fact my lil BAV (I've become quite attached to it )was spared because it still looked to be in great shape.

 

[skeptic49]

5 cm or growth rate of .5 cm or more in a year or less or sharp chest or back pains and it's time to get it done immediately.

Jim

 

[ALCapshaw2]

The liklihood of an Aneurism Rupturing or Disecting is a continuous function, most likely with a Normal Distribution Curve (mathematical definition) .

It is NOT a Step Function (i.e. the notion that it will fail at 5.5 cm but you are safe at 5.4 is TOTALLY BOGUS).

Don't forget that Ross' aneurism "Blew" at 4.7 cm.

I guess his aneurism hadn't read the Medical Text Book Claim that 5.0 or 5.5 is the Magic Number to trigger a failure.

When it comes to Valves and Aneurisms, MY preference is to rely on the opinion of SURGEONS who are more keen on Fixing the Problem BEFORE there is Permanent Damage.

The survival rate for a Ruptured or Disectected Aneurism is less than 10%, assuming you can get to a Surgeon in time.

Just my Non-Professional Opinion.

'AL Capshaw'