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discrepancy between echo and CTA
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). I'm just looking for some reassurance on this page as I recall there was someone else with a similar story. Part of me is terrified that the aneurysm is actually growing that fast .4 cm in 4 months) 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.
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could skipped irregular heartbeats during testing {not afib} give inaccurate measurements for echo and ct scans?
Echo tends to overestimate aortic diameter- reading is only accurate if probe is exactly perpendicular to the aorta, and a slight angle will measure a longer distance. CTA is gold standard, but considerable radiation getting one every 6 months or a year. I’ve asked my cardiologist to do MRA for my screening instead. I’m getting close to 5.0 and not sure if they will want CTA pre-op.
Don’t think premature beats would affect echo aorta measurement. (Retired physician)
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1 ReactionI have had skipped heart beats (PVCs) for as long as I can remember. My aneurysm was found in 2012 and I had either an echo or ct scan every year for 12 years. There was never more than 2 or 3 mm difference between them year to year. My aneurysm slowly grew from 4.5 cm to 5.2 cm over that time and I had surgery 3 months ago. My PVCs were much worse after the surgery but it has slowly been improving.
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1 ReactionI have also had CT and echos since 2005 when an TAA was discovered at 3.9.
I also had an irregular heartbeat as well as mild valve regurgitation. I just had a CT and it is now 4.0 after 20 years. So basically stable despite the irregular heartbeat.
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1 Reactioncould losing weight present bmi 28.00 and getting it down to bmi of 25.00 help reduce CT and ECHO measurements some? aortic aneuysm
I asked for an MRI to avoid radiation. You get with the CT scan. My earlier echo and the MRI matched up in measurements, so that was good to know. I don’t know if that helps you, but that’s what I did.
Has anyone with an aortic aneurysm (Sinus of Valsalva) had surgery OTHER than open heart? My age along with CKD prohibits open surgery.
Most major academic centers that do a high volume of ascending aortic aneurysms surgeries are participating in a clinical trial that uses an endovascular technique - no open heart surgery. You may or may not be a good candidate. It is worth checking into. I know that the aneurysm must be 5.0 cm and that there must be sufficient areas on either side of the aneurysm for them to do the graft.
Thank you for your reply. My aneurysm is at 5 CM and I now in the process of providing Cleveland Clinic with pertinent information for the surgical team to evaluate. Northwestern Memorial in Chicago only does open and I am not a candidate. Finger crossed?
Just mentioned this in another thread about the measurement discrepancies. My non-contrast CT had the smallest, echo was larger, and the contrast CT was accurate, broke the confusioned between the first CT and echod, and is considered the "gold standard" for measurement and it was the largest of all 3. It also was 3D so they actually found one way my root was much larger then another way when rotating it which was very cool. Rapid growth and/or 5 -5.5 seems to be the surgical recommendation these days without any genetic family/disorder.