Appointment with Dr. Pochettino

Welcome, @sbest010. To request a second opinion at Mayo Clinic, you can get started here: http://mayocl.in/1mtmR63

Sometimes, virtual appointments are possible. Mayo Clinic welcomes both new and existing patients for virtual and in-person care, including elective surgeries, in adherence with federal and state executive orders and guidance. Video and phone visits can be great options for appointments before, after or in place of face-to-face care. Appointment coordinators will recommend a virtual visit if it best fits your individual needs.

I'm also tagging fellow members like @jeanern01 @crhp194 @shamilton @rory @morninglory and others who I believe have consulted with Dr. Pochettino. They can share their experiences.

@sbest010, by starting the request submission either online or by phone, you'll talk with an appointment scheduler who can advise on the possibility of a virtual appointment and more. You're right that 4.2 dilation in and of itself may not meet a surgical threshold, but clearly you have additional concerns that you'd like to address.

Thank you for taking the time to respond. I will definitely be pursuing this matter.

I believe that Dr Pochettino is one of the best if not the best. He along with a vascular surgeon operated on me for an aneurysm. This happened in 2016. Obviously this is 2024 so I would rate his surgery a total success. I suffered no infections or any symptom out of the ordinary. Cannot recommend anyone higher.

Thank you for your response. I am seeking an appointment with him based on my research but I was wondering if he ever did virtual appointments and how difficult it is to obtain an appointment. Some of the physicians have a waiting list up to a year.

I understand the aneurysm tend to be slow growing but I have presenting symptoms of difficulty swallowing and intermittent hoarseness so I know the aneurysm is pressuring on the nerve to the larynx so the sooner the appointment the better.

I am so grateful for these forums and the people that take the time to respond.

The discovery came as an incidental finding so I am trying to educate myself the best I can. Thank you

I did an in person consult with Dr.Pochettino. Him and his team were awesome. They did a great job replacing part of my aortic arch and left subclavian in 2019, and I am doing great! Would highly recommend him and Mayo for a consult. I flew there from Florida for my surgery and would not hesitate to do it again. I also had Dr.Bower do a vascular surgery at the same time- he was great as well.
Best wishes
Jeane

I had a Type A-1 complete dissection in 2015 repaired by emergency surgery at UCSD. The difficulty swallowing and hoarseness likely come from the fact that your aorta is enlarged and pressing up against your esophagus. I had serious difficulty swallowing before (and still after) my dissection. Think of it like this overly simplistic analogy: an aortic aneurysm is like a water balloon inside of your chest, slowly stretching, and getting bigger over time. If it breaks, you're in big trouble. In 2021, I saw 8K High-Def CT Scan Images in 3D at the University of Minnesota during my semi-annual scans after surgery. The U of M imaging center at Fulton Street in Minneapolis is FANTASTIC for follow up annual surveillance scans. I literally could see my aorta pressed against my esophagus. Following two open heart surgeries (one to repair and one to close me up and check for leaks three days later) I had to have throat surgery to repair my vocal cords. So, I think that it's smart to get a second opinions--especially if you're having trouble swallowing. Unless this has happened to you, and you happen to be a thoracic surgeon, it's hard for doctors to sometimes grasp the little things that precede a dissection. There were huge red flags in my life that I did not see until after it dissection (trouble swallowing was a big one). I would strongly recommend a second opinion at Mayo, Cleveland Clinic, and my favorite UCSD-San Diego. Find a thoracic surgeon that has done lots of these and has been around for 30 years. You're right to be concerned and right to get a second. You're going to be fine.

Thank you for vocalizing your confidence about him and so happy to hear you are doing well.

I will definitely be pursuing an appointment. I find the symptoms that I am having to be very concerning and the previous physician simply dismissed the need for more active monitoring based on the size of 4.2.

My concern is also the scan showed mild atherosclerotic plaque at the site of the aneurysm and I know a damaged vessel will attract more plaque placing more pressure on the aneurysm.

I appreciate any and all education that can be offered.

Thank you everyone for taking the time to address my concerns.

Moonboy thank you for your detailed response and advice. I truly hope you are doing well now.

My symptoms are what is driving my concern. As stated I know 4.2 doesn’t usually meet the threshold for surgery but bring small in stature at 5ft and presenting with the dysphagia and hoarseness, I agree the aneurysm has expanded and is applying pressure.

If you could please describe the other red flags mentioned in your post I would greatly appreciate it. I have researched them but it is different when vocalized by someone that has experienced it. I am so sorry for what you went through and thank you all for being so gracious to share your knowledge.

I say ditto to the reply above! I, also had aorta aneurysm surgery in 2016 with Dr. Pochettino and believe is the best of the best!!! My age at the time was around 76 and I came thru with no issues.

Thank you morninglory. So glad the surgery went well for you.

If anyone has any advice they care to offer regarding what to ask at the appointment or the symptoms looking back they wish they would have heeded, I would appreciate it.

Again I appreciate the time everyone took to respond. It helps to not feel isolated when such a serious diagnosis is given.