1. < Aortic Aneurysms

I have a dissection in my entire aorta. I also have questions...

Posted by martinkennot @martinkennot, Jul 21 7:28pm

So the ascending type A dissection was treated, and I have the type B residual dissection from the top of the aortic arch down to the left and right iliac arteries.
What is the length of type-B usually? is it a small tear and watch it for a while? Or is it a long tear and medication to suppress aneurysms?
Obviously I cannot have a stent in my entire aorta so medication is a way to "control" it.
But is this normal/usual? Because I don't know if they are going to do anything about it other than just monitor it?

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christine5 | @christine5 | Jul 22 6:36am

I.
Dissected a and B in 2012. My a was repaired and my b. Is medically managed my b is now.4.0 at some points.

I have been told that to fix.The entire b is a very major surgery because they have to deal with the extreme arteries in your system.

It can be done. Usually a Type b is medically managed until.
Something gets too big.
Then they will go in and fix that area.

I'm here to answer any questions you might have specifically. God bless

REPLY
wayne3382 | @wayne3382 | Aug 31 10:09pm

I was in the same circumstance. Emergency surgery to keep me ticking (aortic root, St Jude valve, dacron graft). I am/was dissected all the way down to illiac and renal.

After ascending repair I was on watch for aneurysm developing in defending aorta. There is a lot of pressure in your aortic root and ascending aorta. A little less once it gets past the arch. I made it 8 years and then had to get 2nd open heart surgery for descending side. They has to do what's called the elephant trunk procedure (replaced from first graft the entire arch and some way down with more dacron. Then went back in a week later to stent all the way up into the repair. Also stented illiac and renal dissections. Good times...

They will monitor and then when it weakens and forms an aneurysm they will have to go in again. Hopefully you will only need some stents instead of a full blown rebuild. Does it suck. Yup. But it is absolutely amazing what the surgeons can do nowadays. Best of luck and don't skip any of your follow up scans they are super important.

REPLY
2 replies
martinkennot | @martinkennot | Sep 1 7:10am
In reply to @wayne3382 "I was in the same circumstance. Emergency surgery to keep me ticking (aortic root, St Jude..." + (show)
@wayne3382

I was in the same circumstance. Emergency surgery to keep me ticking (aortic root, St Jude valve, dacron graft). I am/was dissected all the way down to illiac and renal.

After ascending repair I was on watch for aneurysm developing in defending aorta. There is a lot of pressure in your aortic root and ascending aorta. A little less once it gets past the arch. I made it 8 years and then had to get 2nd open heart surgery for descending side. They has to do what's called the elephant trunk procedure (replaced from first graft the entire arch and some way down with more dacron. Then went back in a week later to stent all the way up into the repair. Also stented illiac and renal dissections. Good times...

They will monitor and then when it weakens and forms an aneurysm they will have to go in again. Hopefully you will only need some stents instead of a full blown rebuild. Does it suck. Yup. But it is absolutely amazing what the surgeons can do nowadays. Best of luck and don't skip any of your follow up scans they are super important.

Jump to this post

My type B has split further up into the brachiocephalic and down into the left renal. There is no impairment but I am concerned about the bc artery.
Blood clots esp.
Thanks Wayne for sharing your history. I think it is a fair prognosis for myself.

REPLY
1 reply
wayne3382 | @wayne3382 | Sep 1 8:38am
In reply to @martinkennot "My type B has split further up into the brachiocephalic and down into the left renal...." + (show)
@martinkennot

My type B has split further up into the brachiocephalic and down into the left renal. There is no impairment but I am concerned about the bc artery.
Blood clots esp.
Thanks Wayne for sharing your history. I think it is a fair prognosis for myself.

Jump to this post

Wayne to be an overachiever! I also dissected up into my left carotid. I assume you are on anti coagulates and metoprolol. These will help with the risk of blood clots, and rate and pumping strength of your heart.

Of course they come with other issues but....

As for the worrying part. I am anxiety ridden and on high alert for every skip of my heart and little pain. My "first" surgery was 16 years ago. 16 years of angst over something I have zero control over. "they" keep telling me to enjoy my life and keep up with checkups etc I am now in the same place as everybody else who's alive. I wish it was that easy.

Obviously everyone handles things differently. My hope for you is that you can manage to balance "happy to be alive" with "the sword of Damocles". 16 years and I'm still trying and now dealing with older people problems lol. (I was 48 when this adventure started). I look around at the general population and the pleathera of walkers/oxygen tanks/limps/shortness of breath etc etc etc. The difference between us and them is the wakeup call we got of our mortality,

Wow! I didn't expect to get all Socrates on you! Sorry 'bout that! Best of luck, always here to help (?)

REPLY
2 replies
wayne3382 | @wayne3382 | Sep 1 8:40am

I meant WAY to be an over achiever!

REPLY
pamela78 | @pamela78 | Sep 1 10:02am
In reply to @wayne3382 "Wayne to be an overachiever! I also dissected up into my left carotid. I assume you..." + (show)
@wayne3382

Wayne to be an overachiever! I also dissected up into my left carotid. I assume you are on anti coagulates and metoprolol. These will help with the risk of blood clots, and rate and pumping strength of your heart.

Of course they come with other issues but....

As for the worrying part. I am anxiety ridden and on high alert for every skip of my heart and little pain. My "first" surgery was 16 years ago. 16 years of angst over something I have zero control over. "they" keep telling me to enjoy my life and keep up with checkups etc I am now in the same place as everybody else who's alive. I wish it was that easy.

Obviously everyone handles things differently. My hope for you is that you can manage to balance "happy to be alive" with "the sword of Damocles". 16 years and I'm still trying and now dealing with older people problems lol. (I was 48 when this adventure started). I look around at the general population and the pleathera of walkers/oxygen tanks/limps/shortness of breath etc etc etc. The difference between us and them is the wakeup call we got of our mortality,

Wow! I didn't expect to get all Socrates on you! Sorry 'bout that! Best of luck, always here to help (?)

Jump to this post

Get as Socrates as you like. You've been through so much and at such a young age. No wonder you're anxious. One of my ex-husbands (now deceased) used to say, the biggest difference between people is between the sick and the well. An aneurysm isn't exactly an illness or a sickness, but it certainly does put you in a different category from 90 yr. olds running marathons.

REPLY
tess55 | @tess55 | Sep 1 11:26am
In reply to @wayne3382 "I was in the same circumstance. Emergency surgery to keep me ticking (aortic root, St Jude..." + (show)
@wayne3382

I was in the same circumstance. Emergency surgery to keep me ticking (aortic root, St Jude valve, dacron graft). I am/was dissected all the way down to illiac and renal.

After ascending repair I was on watch for aneurysm developing in defending aorta. There is a lot of pressure in your aortic root and ascending aorta. A little less once it gets past the arch. I made it 8 years and then had to get 2nd open heart surgery for descending side. They has to do what's called the elephant trunk procedure (replaced from first graft the entire arch and some way down with more dacron. Then went back in a week later to stent all the way up into the repair. Also stented illiac and renal dissections. Good times...

They will monitor and then when it weakens and forms an aneurysm they will have to go in again. Hopefully you will only need some stents instead of a full blown rebuild. Does it suck. Yup. But it is absolutely amazing what the surgeons can do nowadays. Best of luck and don't skip any of your follow up scans they are super important.

Jump to this post

Wow! Your story is inspirational. You have been through a lot and modern medicine can work miracles nowadays!

REPLY
1 reply
martinkennot | @martinkennot | Sep 1 6:56pm
In reply to @wayne3382 "Wayne to be an overachiever! I also dissected up into my left carotid. I assume you..." + (show)
@wayne3382

Wayne to be an overachiever! I also dissected up into my left carotid. I assume you are on anti coagulates and metoprolol. These will help with the risk of blood clots, and rate and pumping strength of your heart.

Of course they come with other issues but....

As for the worrying part. I am anxiety ridden and on high alert for every skip of my heart and little pain. My "first" surgery was 16 years ago. 16 years of angst over something I have zero control over. "they" keep telling me to enjoy my life and keep up with checkups etc I am now in the same place as everybody else who's alive. I wish it was that easy.

Obviously everyone handles things differently. My hope for you is that you can manage to balance "happy to be alive" with "the sword of Damocles". 16 years and I'm still trying and now dealing with older people problems lol. (I was 48 when this adventure started). I look around at the general population and the pleathera of walkers/oxygen tanks/limps/shortness of breath etc etc etc. The difference between us and them is the wakeup call we got of our mortality,

Wow! I didn't expect to get all Socrates on you! Sorry 'bout that! Best of luck, always here to help (?)

Jump to this post

Wayne. Anticoags because of the AVR. Metoprolol at first but then changed to Bisoprolol, and then they laddered up the bisop and the perindopril to max dosage. I was also having palpitations but these stopped when they increased the bisop to max level. currently laddering perind until I hit max just short of renal impairment. And I have a statin for arterial strengthening.
I was anxious during the palpitations but these have gone and now I just feel almost completely normal. Almost.
I think I have the elephant trunk but I haven't seen the surgeon since the morning of surgery.
I don't know how they are going to stent the entire aorta.
And Socrates is fine. An old friend actually.

REPLY
1 reply
martinkennot | @martinkennot | Sep 1 6:59pm
In reply to @tess55 "Wow! Your story is inspirational. You have been through a lot and modern medicine can work..." + (show)
@tess55

Wow! Your story is inspirational. You have been through a lot and modern medicine can work miracles nowadays!

Jump to this post

Had I known in advance what they were going to do, the surgery would not have been successful. The less I knew, the better.
I was not a planned surgery, I didn't have a known condition, and no "power of the internet" to guide me. I just listened to the doctors on the day and they deliberately minimized the procedure/s I was about to have. I really thought I was going home and come back later for a check up.

REPLY
wayne3382 | @wayne3382 | Sep 2 9:22am
In reply to @martinkennot "Wayne. Anticoags because of the AVR. Metoprolol at first but then changed to Bisoprolol, and then..." + (show)
@martinkennot

Wayne. Anticoags because of the AVR. Metoprolol at first but then changed to Bisoprolol, and then they laddered up the bisop and the perindopril to max dosage. I was also having palpitations but these stopped when they increased the bisop to max level. currently laddering perind until I hit max just short of renal impairment. And I have a statin for arterial strengthening.
I was anxious during the palpitations but these have gone and now I just feel almost completely normal. Almost.
I think I have the elephant trunk but I haven't seen the surgeon since the morning of surgery.
I don't know how they are going to stent the entire aorta.
And Socrates is fine. An old friend actually.

Jump to this post

Probably won't see much of the surgeon except for 5 minutes of "Everything looks good" once a year. He's off to saving the next unfortunate member of the zipper club.

Develope a good relationship with a good cardiologist. They will be the ones looking at echos, ekgs, heart monitors, meds etc etc etc and being way too relaxed when telling you "yeah that's nothing to worry about" now that you're aware of every ache and pain and heartbeat. Easy peazy when it's not his heart! lol.

Sounds like you're well on your way to your new "normal". If it helps...I try to be blissfully unaware of how surgeons do anything. I won't even look at a CT scan or echo etc. I also steer clear of Dr Google lest it sear into my over active imagination the bredth and scope of what happened. I love learning about fascinating things, As long as it's on other people haha.

REPLY
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