What is the correct cm in thoracic aorta ansersym to have surgery

A consensus document appeared in Nov 2022 by the aortic disease group. I posted the link to the ACC/AHA document in Circulation a few days ago. Just google “aortic disease consensus.” This document lowered the number from 5.5 cm to 5 cm. However this has been controversial. A very good study came out by Kaiser which argued (based on evidence from a controlled trial) that if the patient is “managed” the number can and should be higher than 5.0.
The finding that you have connective tissue disorder may increase your risk.
You need the advice of a surgeon at a high vilume center. However, we have found that surgeons can disagree. You are the final decision maker. Read everything you can and make informed decisions.

37!centers are now doing EVAR surgeries for AAA as part of an investigational clinical trial. You may qualify. There are many exclusions - eg you must have emough “landing area” on either side of the aneurysm. (That excluded my husband.)
Almost everybmajor academic center is part of this trial.

I had high hopes of being accepted into this Trial at the major medical center where my ascending aortic aneurysm is monitored by a Cardiothoracic surgeon specializing in diseases of the Aorta. I too did not have a sufficient landing zone which is a requirment to participate in the trial. To say I was disappointed is ann understatement. Open heart surgery is my only option at this time at 5.5cm.

AAA is Ascending Aortic Aneurysm. I am followed by a Cardiothoracic surgeon specifializing in aortic diseases at a major medical center. EVAR/TEVAR is not an option for me as I do not have sufficient landing zone to secure the graft.

Find yourself a Cardiothoracic surgeon specializing in diseases of the Aorta. Clearly your cardiologist is not current with the monitoring guidelines used by the cardiothoracic aortic specialist.

My husband and I were similarly disappointed. He is at 5.0 cm now but this growth has been very slow. He was at 4.3 in 2007 and 4.9 in 2021, we were not forewarned in 2007 and so my husband continued to do heavy lifting and all the things that probably made the aneurysm increase in size.

If you healthy, physically fit for the surgery and your at 5.5 cm .Insurance is good, can’t think of a reason to wait Good luck.

I’ve read heavy lifting is a no no with boarder line arota If 5.0 cm is still the cut off for surgery your husband is very close . But also doesn’t mean he has an immediate issue . It may never get to 5.0 and it could change this year ,unpredictable . I’ve had a 4.3 for years . I have lots of heart issues none of my doctors have even mentioned it to me after all the tests I’ve had over the years . So just make sure your doctor is aware of it during visits. And it never hurts to get a second opinion . Good luck

He sees a aortic surgeon at Mayo. The 5.0 consensus (Nov 2022) included studies of patients that were not aware and not “managed.” Kaiser almost immediately came out with well done studies showing that “managed patients” without risk factors like vasculitis, other connective tissue disorders, etc., could go well beyond the 5.0 cm number with minimal risk.
My husband’s surgeon feels that given the stability of my husband’s aneurysm (1 mm increase since Jan 2021 and 6 mm increase from 2007 to 2021) that if he behaves himself (keeps bp low, , no lifting) he may never need surgery - die of something else; he is 81 but in good health. When and if his aneurysm gets to 5.5 that will be a different conversation.

Yes I think all things should be taken into consideration including growth over time ,the patient age, and of course peace of mind . If you trust you doctors then peace of mind should not come at a cost and you and your husband will comfortable with your decision. Good Health ✌️