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Help Understanding First/One-year Size Monitoring Scan

Posted by bitsygirl @bitsygirl, Apr 12, 2024

I am looking for some input on the measurement of an ascending aortic dilation/aneurysm. Long story short of the measurements:

First measurement was a calcium CT. 4.5 cm
Second measurement was coronary CT angiogram (for other reasons): 4.3 cm (just a couple of months after the calcium CT)
First follow up scan almost exactly one year after the calcium CT: 4.7 w/o contrast. 4.5 w/contrast.

I know there is some error in the scans. I am a little overwhelmed trying to pin it down. Does anyone know if there's any chance this thing has not grown or is under 4.5cm?

Thanks!

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fjc1962 | @fjc1962 | Apr 23, 2024
In reply to @smarsili "I had a sinus of valsalva aneurysm, between where the aorta meets the heart and just..." + (show)
Profile picture for smarsili @smarsili

I had a sinus of valsalva aneurysm, between where the aorta meets the heart and just below the coronary artery.
It measured 5.2cm for over a year with no change. I elected to have surgery because there were 2 threats, rupture and if it grew any it may pinch the coronary artery and cause a heart attack.
Once in to correct the problem the surgeon noted it was larger than originally discussed.
It has been 5+ weeks now and I am starting to get back to my normal routine, feeling better and stronger everyday.
It is a process, but I am very happy that I did this.

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Congratulations on your successful surgery. What a relief that must be for you. I can only pray for that outcome. Where did you choose to have your surgery performed? God bless!

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mdw100 | @mdw100 | Apr 23, 2024

My doctor said that 2to 3 cm is not a big deal in margins error with the scans or tests. I have had the same for many years, lost count and started at 4:2 and now it’s at 4:5 in last check but not worrying. My momma has had an aneurysm in her brain started when she was in her 70s now she’s 93 and still alive. Just love life and leave the rest to God. “All the days ordained for you was written in His book before one of them came into being”. Psalm 139:16

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smarsili | @smarsili | Apr 23, 2024
In reply to @fjc1962 "Congratulations on your successful surgery. What a relief that must be for you. I can only..." + (show)
Profile picture for fjc1962 @fjc1962

Congratulations on your successful surgery. What a relief that must be for you. I can only pray for that outcome. Where did you choose to have your surgery performed? God bless!

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I had my surgery done at Mayo Clinic in Phoenix. Very thorough, and very professional

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fjc1962 | @fjc1962 | Apr 23, 2024

Thanks for sharing that information. So good to hear. I’m seeing a surgeon at Mayo Clinic in Florida. But, I was wondering if I should have a consultation at Cleveland Clinic before I have to make the decision.

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chrisn61 | @chrisn61 | Aug 22 9:33am
In reply to @smarsili "I had a sinus of valsalva aneurysm, between where the aorta meets the heart and just..." + (show)
Profile picture for smarsili @smarsili

I had a sinus of valsalva aneurysm, between where the aorta meets the heart and just below the coronary artery.
It measured 5.2cm for over a year with no change. I elected to have surgery because there were 2 threats, rupture and if it grew any it may pinch the coronary artery and cause a heart attack.
Once in to correct the problem the surgeon noted it was larger than originally discussed.
It has been 5+ weeks now and I am starting to get back to my normal routine, feeling better and stronger everyday.
It is a process, but I am very happy that I did this.

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I have a 4.8 at the sinus of Valsalva. Found it when I got a CT scan after my brother died unexpectedly from a heart event. Unfortunately, we don't know what his issue was. I've been to both Mayo and the Cleveland Clinic and am on a monitor it for now plan. Will be going back to Mayo next spring for another measurement. It has not grown since it was discovered 15 months ago.....

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ppiper | @ppiper | Aug 23 11:56am
In reply to @bitsygirl "@mplopez5 Thanks for your input. I've continued to search and I'm pretty sure the margin of..." + (show)
Profile picture for bitsygirl @bitsygirl

@mplopez5 Thanks for your input. I've continued to search and I'm pretty sure the margin of error in the measurement is at least a couple of millimeters. Yet, I guess the surgeons have to work within this regardless. I found a YouTube video in which a vascular surgeon described his process for deciding when to intervene surgically. I should have bookmarked it.

I'm overthinking the reasons behind this meeting, but I am guessing he may be using what seems to be an increasingly used measure of risk: aortic cross-sectional area to height. (An overview is here: https://consultqd.clevelandclinic.org/improving-risk-stratification-dilated-aorta-trileaflet-aortic-valve/.) By that measure, I might be at non-trivial risk. We'll see. I can live with whatever is the outcome of the meeting. I don't think I'm at high absolute risk regardless and the wave of panic has subsided. 🙂

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That sounds like a helpful article but your link brings me to the journal itself. Is there any possibility of a link to the actual article? Thank you and best wishes.

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luhn | @luhn | Aug 23 9:31pm
In reply to @ppiper "That sounds like a helpful article but your link brings me to the journal itself. Is..." + (show)
Profile picture for ppiper @ppiper

That sounds like a helpful article but your link brings me to the journal itself. Is there any possibility of a link to the actual article? Thank you and best wishes.

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Try this...I was having difficulty with the other link also. Hope this works!
https://my.clevelandclinic.org/departments/heart/patient-education/-/scassets/86da6d9cbf24437d9037875f57ea7c71.ashx It is Cleveland Clinic Aortic Aneurysm Guide found on Google search.

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ppiper | @ppiper | Aug 24 9:38am
In reply to @luhn "Try this...I was having difficulty with the other link also. Hope this works! https://my.clevelandclinic.org/departments/heart/patient-education/-/scassets/86da6d9cbf24437d9037875f57ea7c71.ashx It is..." + (show)
Profile picture for luhn @luhn

Try this...I was having difficulty with the other link also. Hope this works!
https://my.clevelandclinic.org/departments/heart/patient-education/-/scassets/86da6d9cbf24437d9037875f57ea7c71.ashx It is Cleveland Clinic Aortic Aneurysm Guide found on Google search.

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Thank you. This is a good overview article from Cleveland. I was hoping for the article that refers to cross-sectional area as a prognostic indicator, but perhaps that one will reappear. I have found a way on my computer to measure the actual length, diameter, area, etc from the images MGH downloaded on my portal. Amazing, and I’m trying to assess from these different articles.
Best wishes to all on this journey!

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luhn | @luhn | Aug 25 12:08am
In reply to @ppiper "Thank you. This is a good overview article from Cleveland. I was hoping for the article..." + (show)
Profile picture for ppiper @ppiper

Thank you. This is a good overview article from Cleveland. I was hoping for the article that refers to cross-sectional area as a prognostic indicator, but perhaps that one will reappear. I have found a way on my computer to measure the actual length, diameter, area, etc from the images MGH downloaded on my portal. Amazing, and I’m trying to assess from these different articles.
Best wishes to all on this journey!

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Oh wow. I'm not able to download images, well not so far anyway 🙂 ... nice work!

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ppiper | @ppiper | Aug 25 11:06am

I think I put the technique on another Mayo thread but, if you have images in your cardiologist’s report, can open the image in your computer, then the instructions might work. Always can repeat them here if needed.

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