Aortic Aneurysms – Introduce yourself & meet others

I am age 78 . I am concerned about being older and facing open heart stent repair for ascending aortic aneurysm. What have been your experierences post surgery?

Hi everyone. I just joined this site today. Last week after having an x-ray I was diagnosed with an aortic aneurysm 4.0cm. It is Sunday today so I haven’t been able to talk to any other doctors or to any doctors for that fact. I also have rheumatoid arthritis which I guess can be a factor also again not sure. It seems kind of scary to me. My question to everyone is, should I be concerned?

You're going to be OK. You came to the right place. Now that you know you have a problem you can work at reducing your risks and prepare yourself to have open-heart surgery to repair it if necessary. You are 95% of the way there because you know you have a problem and you can do something about it. For many of us, me included we did not know we had a problem until we had a complete aortic dissection. Most people who have that sort of event don't survive. I am lucky and I am thankful to have survived in 2015, but I sure wish I would've known I had a problem because I would've addressed it.

In your case, you're much more likely to survive an aortic surgery for repair that is done in a scheduled and controlled manner, as opposed to an emergent operation which often times you won't even live long enough to get to the hospital. So, being in a 3.9 means that your doctor will likely tell you that they will not operate until you reach a 5.0. That's fairly normal, but it depends upon your size, gender, age, etc. 5 cm is the typical demarcation point for having open-heart surgery to repair the aorta. I'm so happy for you that you know you have a problem because now you can confidently make adjustments in your life that will make it less likely that you will have a sudden aortic dissection. Regular CT scans with contrast of your heart and your vasculature will save your life. Make it a habit to see your fully qualified thoracic surgeon with expertise in aortic repairs. She or he are your best friend and the sooner you get to know them and have regular appointments with them the better your chances are of surviving. Keep your blood pressure down, keep your weight down, keep your stress down, and listen to your medical team, especially your thoracic surgeon. Peace.

Is open heart surgery the only way to fix an aortic aneurysm? Is there not other ways. Also is there a heart doctor on group discussion that answers some of our questions?

I'm not a doctor. I am a survivor of a Type A-1 aortic dissection repaired by open heart surgery in 2015. Think of your aorta as more or less a big candy cane coming off of the top of your heart. My aorta dissected, meaning that split, at the top of that candy cane coming out of my heart. In actuality, your aorta is made up of three layers of tissue. A the section generally occurs when the layers of that tissue are separated and blood flows through that separation, forcing the dissection down the aorta until it either stops or it dissects entirely. It is incredibly painful. I can assure you, you do not ever want to happen to you. It was simply the most excruciating pain I've ever been in in my life.

In answer to your question, there really isn't any way to repair an ascending aorta without cracking your chest open (YET). There is a lot of medical research going on and I suspect at some point in the future, they will have a way to go in and make this repair robotically in some cases. But, at the end of the day you're trying to fix a beating heart with several liters of blood flowing through it every minute and you need good clear and open access to be able to see what you're doing and what needs to be fixed. When I had my surgery, I was left in a coma for a couple of weeks because the sutures between my heart and the artificial aorta that they implanted in me were leaking blood. I'm not sure precisely how you would propose to robotically get inside my chest to address that bleeding problem. The way it was addressed for me is that they left me in a coma and left my chest open until they were satisfied that I was no longer bleeding from where the aortic graft had been installed. The aortic graft looks like a small vacuum hose, which is flexible and made of Dacron nylon and is 13 inches long and and 1.25" in diameter. My graft was made by a company called WL Gore, which is the same company that makes Goretex waterproof, clothing and boots. I thank them every day for being alive.

As much as I love technology, and as much as I believe in the future of artificial intelligence, I do think there are some physical limits for how certain things can be repaired. Mechanically, your aorta is about 1 1/2 times the size of a garden hose. Your body needs to be put on a cardio bypass machine and/or ECMO in order to continue your blood flow while your aorta is repaired and keep you alive. Every drop of your blood passes through your aorta and goes on through the rest of your vasculature to provide oxygenated blood throughout your body. By analogy, your aorta is the main highway within your body with auxiliary, roadways trails, and paths off of it. In order to effectively get to where you need to go, a surgeon needs to do a median sternotomy, which is a medical term for cracking your chest open.

On the other hand, if you have an abdominal aortic aneurysm, which is further down the aortic trunk toward your stomach, there are some newer techniques that allow doctors to go in endovascularly and do a thing called an elephant trunk repair. That's basically where they go through a small cut in your femoral artery in your thigh and then feed up a large Dacron stent and deploy it without stopping your heart. That's possible today without the sternotomy for abdominal aortic aneurysms (AAA). You MIGHT be able to repair a AAA without massive surgery, but the doctors are still going to be going in through the groin.

Nature has essentially given all of us a protective shell over the top of a very important organ, namely the heart which is protected by the sternum and a rib cage. This protective shell is great when we're trying to protect our vital organs behind it, but it gets in the way of a surgeon who needs to access those organs to make repairs. The sterum needs to be opened up and retracted in order for a doctor to repair our hearts.

Lastly, I don't know whether or not there were any doctors on this blog. I doubt it, but their input is welcome. Peace.

I'm not a doctor. I am a survivor of a Type A-1 aortic dissection repaired by open heart surgery in 2015. Think of your aorta as more or less a big candy cane coming off of the top of your heart. My aorta dissected, meaning that split, at the top of that candy cane coming out of my heart. In actuality, your aorta is made up of three layers of tissue. A the section generally occurs when the layers of that tissue are separated and blood flows through that separation, forcing the dissection down the aorta until it either stops or it dissects entirely. It is incredibly painful. I can assure you, you do not ever want to happen to you. It was simply the most excruciating pain I've ever been in in my life.

In answer to your question, there really isn't any way to repair an ascending aorta without cracking your chest open (YET). There is a lot of medical research going on and I suspect at some point in the future, they will have a way to go in and make this repair robotically in some cases. But, at the end of the day you're trying to fix a beating heart with several liters of blood flowing through it every minute and you need good clear and open access to be able to see what you're doing and what needs to be fixed. When I had my surgery, I was left in a coma for a couple of weeks because the sutures between my heart and the artificial aorta that they implanted in me were leaking blood. I'm not sure precisely how you would propose to robotically get inside my chest to address that bleeding problem. The way it was addressed for me is that they left me in a coma and left my chest open until they were satisfied that I was no longer bleeding from where the aortic graft had been installed. The aortic graft looks like a small vacuum hose, which is flexible and made of Dacron nylon and is 13 inches long and and 1.25" in diameter. My graft was made by a company called WL Gore, which is the same company that makes Goretex waterproof, clothing and boots. I thank them every day for being alive.

As much as I love technology, and as much as I believe in the future of artificial intelligence, I do think there are some physical limits for how certain things can be repaired. Mechanically, your aorta is about 1 1/2 times the size of a garden hose. Your body needs to be put on a cardio bypass machine and/or ECMO in order to continue your blood flow while your aorta is repaired and keep you alive. Every drop of your blood passes through your aorta and goes on through the rest of your vasculature to provide oxygenated blood throughout your body. By analogy, your aorta is the main highway within your body with auxiliary, roadways trails, and paths off of it. In order to effectively get to where you need to go, a surgeon needs to do a median sternotomy, which is a medical term for cracking your chest open.

On the other hand, if you have an abdominal aortic aneurysm, which is further down the aortic trunk toward your stomach, there are some newer techniques that allow doctors to go in endovascularly and do a thing called an elephant trunk repair. That's basically where they go through a small cut in your femoral artery in your thigh and then feed up a large Dacron stent and deploy it without stopping your heart. That's possible today without the sternotomy for abdominal aortic aneurysms (AAA). You MIGHT be able to repair a AAA without massive surgery, but the doctors are still going to be going in through the groin.

Nature has essentially given all of us a protective shell over the top of a very important organ, namely the heart which is protected by the sternum and a rib cage. This protective shell is great when we're trying to protect our vital organs behind it, but it gets in the way of a surgeon who needs to access those organs to make repairs. The sterum needs to be opened up and retracted in order for a doctor to repair our hearts.

Lastly, I don't know whether or not there were any doctors on this blog. I doubt it, but their input is welcome. Peace.