Connect
← Return to Early surgery: Can I get aortic aneurysm repair before it's 5.0?
Discussion
Early surgery: Can I get aortic aneurysm repair before it's 5.0?
Aortic Aneurysms | Last Active: 4 days ago | Replies (81)Comment receiving replies
I am a 63 YO female. They found an Ascending aortic aneurysm incidentally, measuring 3.8. I prefer to "fix" the problem rather than taking Rx - which are just as risky as surgery. Who says prescriptions are the conservative route? The pharmaceutical industry? The side effect risk of drugs is real, and I don't wish to treat the symptoms only to find out I'll have to surgically address the AAA when I'm older. My father had an AAA. Do I need to get DNA testing to make a case? What surgical options do I have?
Replies to "I am a 63 YO female. They found an Ascending aortic aneurysm incidentally, measuring 3.8. I..."
Connect
A 3.8 cm ascending aortic aneurysm is on the smaller side and, in most cases, doesn't require immediate surgery. The general approach is surveillance with imaging to track growth over time, since most aortic aneurysms don’t suddenly rupture unless they reach a much larger size, typically over 5.0–5.5 cm. That said, every case is different, and family history—especially if your father had an aneurysm—can be a factor in risk assessment.
Medication isn’t about "treating symptoms"; it's about reducing stress on the aortic wall to slow growth and prevent complications. Beta-blockers and ARBs, for example, have been shown in some studies to reduce aneurysm expansion rates. The risks of medications exist, of course, but they are generally low compared to the risks of early surgery. Surgery has its own set of serious risks, including stroke, infection, and complications related to bypass circulation. It's not that surgery isn’t an option—it’s that timing is everything.
Trust me, I had open-heart surgery to repair my burst aorta in 2015. It is an absolute nightmare. Recovery is long, painful, and physically and emotionally draining. If there had been any alternative, I would have taken it. I do not believe I would undergo open-heart surgery if it were merely optional. I’m also not sure you’re going to find a surgeon who will want to operate just because you say you want it. Most will follow the established guidelines, which weigh the risks of surgery against the risks of aneurysm progression.
Genetic testing could be useful if there’s a strong family history of connective tissue disorders (like Marfan or Loeys-Dietz syndrome), but it’s not necessary just to "make a case" for surgery. As for surgical options, the standard approach for an ascending aortic aneurysm is an open repair with a synthetic graft. If the aortic valve is involved, some patients may need valve-sparing root replacement (David procedure) or valve replacement, depending on the anatomy. Less invasive options like TEVAR aren’t typically used for ascending aneurysms yet.
Your best next step is to consult with a cardiothoracic surgeon who specializes in aortic disease. A detailed review of your imaging, family history, and overall health will give you a clearer picture of the right path forward.