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Aortic Aneurysms - 4.5CM - Bicuspid Valve

Posted by Fighter @niravani, Sep 4, 2024

I am 50 year old male and diagnose with Aneurysms by accident through CT scan. 4.5CM was the measurement in December 2023. Since I met with Cardiologist and Surgeon and they ask to repeat CT scan and ECHO 6-month later.
I did re-test those and pretty much CT scan showed 4.6CM but a note that compare to the last one, its unchanged and stable.
My Dr. ask to do again in December and if its stable, repeat only ever year.
I went to Cleveland Clinic yesterday as I want to do my surgery there when it comes a time and they did the ECHO that showed my aneurysm of 5.3CM!!!! How is that possible? I just had my ECHO and CT scan in June (2months ago) and they both were 4.6CM and 4.3CM respectively and how Cleveland Clinic result is 5.3CM?

AORTA
The visualized aorta is dilated.
Measurements - Sinus: 3.5 cm.
Mid ascending aorta 4.7 cm.
Distal ascending aorta 5.3 cm.
Mid arch 2.9 cm.

This is scary and don't know what to do! Any advise? Any similar experience?

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marylou78 | @marylou78 | 4 days ago

Glad I found your update that Cleveland Clinic's Echo was inaccurate! I have been trying to find your post as I just went to Cleveland Clinic and had a really similar experience. I was diagnosed with a Bicuspid aortic valve and 4.2 TAA last August via TTE echo. A CTA confirmed aneurism at 4.3 (I'm assuming the .1 difference is well within the margin of error). Anyway, I went to Cleveland Clinic for a 2nd opinion about a week ago (original diagnosis confirmed). However, CC insisted on doing their own TTE echo after my appointment with the Dr. The Dr had told me in advance that TTE echos were primarily for looking at the heart NOT to measure the size of the aorta. However, when I got the results of the echo back it puts the aneurism at 4.6. The CC Dr. doesn't seem concerned, but I'm supposed to follow up with my local cardiologist and have another CTA in March (6 months after first CTA). Part of me is terrified that the aneurysm is actually growing that fast and part of me thinks the CC echo is probably just really inaccurate, which I am surprised that my local Dr.'s echo and CTA would almost be identical, yet CC could possibly be this inaccurate in their echo. Just out of curiosity is the surgeon you are meeting with at CC? If so, did you need a referral from either your local cardiologist or a CC cardiologist? Maybe we both had the same person doing our echo's or something, just very odd indeed.

REPLY
1 reply
Fighter | @niravani | 4 days ago
In reply to @marylou78 "Glad I found your update that Cleveland Clinic's Echo was inaccurate! I have been trying to..." + (show)
@marylou78

Glad I found your update that Cleveland Clinic's Echo was inaccurate! I have been trying to find your post as I just went to Cleveland Clinic and had a really similar experience. I was diagnosed with a Bicuspid aortic valve and 4.2 TAA last August via TTE echo. A CTA confirmed aneurism at 4.3 (I'm assuming the .1 difference is well within the margin of error). Anyway, I went to Cleveland Clinic for a 2nd opinion about a week ago (original diagnosis confirmed). However, CC insisted on doing their own TTE echo after my appointment with the Dr. The Dr had told me in advance that TTE echos were primarily for looking at the heart NOT to measure the size of the aorta. However, when I got the results of the echo back it puts the aneurism at 4.6. The CC Dr. doesn't seem concerned, but I'm supposed to follow up with my local cardiologist and have another CTA in March (6 months after first CTA). Part of me is terrified that the aneurysm is actually growing that fast and part of me thinks the CC echo is probably just really inaccurate, which I am surprised that my local Dr.'s echo and CTA would almost be identical, yet CC could possibly be this inaccurate in their echo. Just out of curiosity is the surgeon you are meeting with at CC? If so, did you need a referral from either your local cardiologist or a CC cardiologist? Maybe we both had the same person doing our echo's or something, just very odd indeed.

Jump to this post

Hi, thank you for sharing your experience. At CC, they would only book me to see cardiologist and once they feel surgery is the option then they would introduce to the surgeon. At least what they told me!
I was just not happy as how come you can have such gap in ECHO and my CT or Echo results! (4.6 vs 5.3?)
Since I did CT and ECHO again and both shown 4.6 and unchanged.
I have made my mind that when time comes, I will do my surgery at the local hospital and surgeon who is very good and has done 800+ surgeries.
He told me that when you go CC like place, most experience surgeon are only there as supervision and actually surgery is done by the junior! While locally, I am assured that the surgeon I see is the same guy going my surgery!
Not impressed at all with CC! Good luck to you.

REPLY
1 reply
nkompa | @nkompa | 4 days ago
In reply to @niravani "Hello Everyone, so Cleveland clinic Cardiologist don't really know as how ECHO can show so much..." + (show)
@niravani

Hello Everyone, so Cleveland clinic Cardiologist don't really know as how ECHO can show so much different results then my previous 2 ECO, 1 TEE and 2 CT scans! My highest to-date result is 4.6CM through CT in June 2024 so having this to grow from 4.6CM to 5.3CM in 2 months is puzzling.

I am going for my CT scan tonight and will see, what is right and wrong but will post to this group to let everyone know so if someone in the same boat, can at least have some reference and guidance unlike me.

Thank you all.

Jump to this post

I hope you have received some peace of mind! I have a bicuspid aortic valve and aortic aneurysm of 4.4 cm (based on recent CT for a lung issue ... very different from the 4.0 on the Echo that I had 6 months prior.) Was told the CT is the measurement that "counts." I'm shifting care to Cleveland Clinic and have these tests scheduled for end of May. It seems this doc wants a comprehensive picture of the situation, which I appreciate! Here's the list of what she ordered, if it helps. Big hugs.

1. MRI CARDIAC VELOCITY FLOW MAP
2. MRI CARDIAC MORPH FUNC WO/W IVCON
3. MRA CHEST CARDIOVASCULAR WO/W IVCON
4. MRA ABDOMEN WO/W IVCON
5. MRA BRAIN WO IVCON
6. EXERCISE STRESS ECG METABOLIC (WITHOUT IMAGING)
7. ECHO SPECIALIST COMPLEX ADULT CONGENITAL
CONSULT TO MEDICAL
8. GENETICS screening

REPLY
pamela78 | @pamela78 | 4 days ago
In reply to @niravani "Hi, thank you for sharing your experience. At CC, they would only book me to see..." + (show)
@niravani

Hi, thank you for sharing your experience. At CC, they would only book me to see cardiologist and once they feel surgery is the option then they would introduce to the surgeon. At least what they told me!
I was just not happy as how come you can have such gap in ECHO and my CT or Echo results! (4.6 vs 5.3?)
Since I did CT and ECHO again and both shown 4.6 and unchanged.
I have made my mind that when time comes, I will do my surgery at the local hospital and surgeon who is very good and has done 800+ surgeries.
He told me that when you go CC like place, most experience surgeon are only there as supervision and actually surgery is done by the junior! While locally, I am assured that the surgeon I see is the same guy going my surgery!
Not impressed at all with CC! Good luck to you.

Jump to this post

This is helpful. My cardiologist told me the same thing about the big medical centers with the reputations. I'm going to make sure I vet the surgeon, feel comfortable with him whoever he turns out to be, and stick to him like glue. I'm 79 and am hoping I never get to the point of needing surgery. As I get older, I'll have more questions. Thank goodness for this group.

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