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pattiej avatar

Should I get a second opinion about surgery?

Aortic Aneurysms | Last Active: Jul 19 9:33am | Replies (43)

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Profile picture for pittsburghdad @pittsburghdad

My doctor told me that, absent any other complicating factors, between 5.0 and 5.5 is normally a bit of a "gray" area where a patient's own views should take precedence. The risk of a dissection in that range are still comparatively low, or as you first doctor said, not "emergent." It's once you hit 5.5 that the risk of dissection starts to go up exponentially. However, the fact that you had GCA does seem significant and would seem to raise your risk. Fundamentally, it's your choice. If you were younger, below 60 like me, then the surgery option might seem more compelling, but as you get older, the recovery from major surgery becomes more challenging, especially if you have any other health conditions. One comment: a variation between 4.8 (below surgical threshold) and 5.3 is pretty wide. I would think that the doctor would want the most precise measurement possible using a gated CT scan with contrast, if that has not already occurred.

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Replies to "My doctor told me that, absent any other complicating factors, between 5.0 and 5.5 is normally..."

You’ve mentioned so many things that I’ve been thinking too! I’ve really wondered about the precision factor when it comes to measurement of the aneurysm. How can there be such a discrepancy in size when the same imaging is measured by different professionals? And especially when size is the defining criterion for surgical intervention, it seems to me that obtaining a very accurate measurement is crucial. I’ve read briefly about gated CT
scans. Seems like they’re hard to get? Maybe not widely available due to needing special equipment and expertise? Or maybe not covered by Medicare? In any case, no, I haven’t had one but it’s certainly a consideration. I’ll ask the cardiothoracic surgeon at my appointment on July 2. Thanks so much for your insight and thoughtful input!