Aortic root and LAD stenosis

I hear everything you’re feeling in this, and it takes me right back to the months after my own emergency Type A aortic dissection in 2015. I was 50, active, and suddenly the ground dropped out from under me when I dissected 1,600 miles from home. Even with good doctors, the uncertainty was the hardest part. I had 42 minutes of thinking about my kids, my wife, and whether I’d still be around followed by three weeks in a coma. That fear is real, and it doesn’t mean anything is actually getting worse. It just means you’re human and you’ve been forced to look at something most people never think about.

A 4.5 aortic root and a 50 percent LAD lesion are things your cardiologist can track very closely. Many people live long, full lives with numbers like yours, especially when they’re already dialed in with statins, Repatha, and LDL reduction. High Lp(a) is frustrating, but you’re already treating the things that can be treated. The fact that your team wants to get your LDL into the 30s is exactly what the guidelines support for someone active and motivated to reduce long-term risk. That’s not a dire prognosis. That’s aggressive prevention.

The emotional piece can hit harder than the medical piece. After my repair and graft, I spent months thinking every twinge was the beginning of the end. What eventually helped was realizing that knowledge, surveillance, and modern cardiology let you stay ahead of this instead of being blindsided by it. You’re monitored. You’re medicated. You’re fit. Nothing here suggests a shortened future, even though it feels that way right now. On workouts, fear can trick you into stopping the very thing that helps stabilize your blood pressure and mood. You don’t have to train like your old self. You just need steady movement, no breath-holding, no straining, no pushing to the red zone. Walking, easy cycling, resistance work without the valsalva. These are safe and they keep your head in a better place.

Retirement plus a new diagnosis can feel like an emotional ambush. That doesn’t mean your life is unraveling. It means you’re adjusting. I’ve been where you are, and it settles with time. You will adapt to this, and your family will still have you. You’re not at the edge of anything. You’re at the beginning of understanding what’s going on so you can protect yourself for the long haul. Peace.

I went to Mayo because I felt like I was dying but the local cardiologist said the LAD was fine after an nuclear perfusion test and stress test. I thought it must be the aortic aneurysm. Jul 22, 2024 to Aug 6 2024, cardiologists at Mayo were trying an angiogram with possible intervention on an extensive coronary fistula from the Right Coronary Artery (RCA) and Left Anterior Artery (LAD) with both going into the pulmonary artery. There was another from the bronchial artery to the pulmonary artery. They already knew about a 4.8 cm root and 4.7 to 4.8 ascending aorta. The ended up not doing anything because the found a 100% chronically occluded mid LAD and an aneurysm on the RCA where it lands near the root. I had an interventional radiologist to block the bronchial fistula with 12 platinum coils on Sep 4 because the surgeon wouldn't be able to get it without moving my heart. On Sep 10th I had an open heart surgey to remove and tie off the complex fistula, resection the aneurysm on the RCA and do a double bypass. We had 3 plans depending on the situation regarding the aorta and root, but wasn't going to do it that day, but coming off bypass etc, the root ruptured and aorta tore, so I ended up with an emergent Bentall procedure based on one of the 3 plans we had discussed. That was over 14 hours of surgery and I am doing fine. I do have to monitor the remaining portion of the ascending aorta because it is at 4.6 CM. The key thing is to find the best team at a facility that specializes in these things and stay on top of it and don't panic. I was 60 y.o. when all of this went down. The fistula business was congenital and was likely there as a child. It turned out that the LAD had been blocked for a while, but the fistula's collaterals had been keeping me alive until they were beginning to cause problems. The regular cardiologist just didn't dig into the "weird" stuff as he put it and assumed it was just an anomaly. That is why its important to see specific cardiologists and cardiovascular surgeons. Moonboy's experience was scarier than mine and that is saying something. Just hang in there and stay on top of it. Your LAD may even be able to corrected with stents, but make sure you ask the ramifications it you have to have surgery in the future for the aneurysm, because a good surgeon can do both.

I hear everything you’re feeling in this, and it takes me right back to the months after my own emergency Type A aortic dissection in 2015. I was 50, active, and suddenly the ground dropped out from under me when I dissected 1,600 miles from home. Even with good doctors, the uncertainty was the hardest part. I had 42 minutes of thinking about my kids, my wife, and whether I’d still be around followed by three weeks in a coma. That fear is real, and it doesn’t mean anything is actually getting worse. It just means you’re human and you’ve been forced to look at something most people never think about.

A 4.5 aortic root and a 50 percent LAD lesion are things your cardiologist can track very closely. Many people live long, full lives with numbers like yours, especially when they’re already dialed in with statins, Repatha, and LDL reduction. High Lp(a) is frustrating, but you’re already treating the things that can be treated. The fact that your team wants to get your LDL into the 30s is exactly what the guidelines support for someone active and motivated to reduce long-term risk. That’s not a dire prognosis. That’s aggressive prevention.

The emotional piece can hit harder than the medical piece. After my repair and graft, I spent months thinking every twinge was the beginning of the end. What eventually helped was realizing that knowledge, surveillance, and modern cardiology let you stay ahead of this instead of being blindsided by it. You’re monitored. You’re medicated. You’re fit. Nothing here suggests a shortened future, even though it feels that way right now. On workouts, fear can trick you into stopping the very thing that helps stabilize your blood pressure and mood. You don’t have to train like your old self. You just need steady movement, no breath-holding, no straining, no pushing to the red zone. Walking, easy cycling, resistance work without the valsalva. These are safe and they keep your head in a better place.

Retirement plus a new diagnosis can feel like an emotional ambush. That doesn’t mean your life is unraveling. It means you’re adjusting. I’ve been where you are, and it settles with time. You will adapt to this, and your family will still have you. You’re not at the edge of anything. You’re at the beginning of understanding what’s going on so you can protect yourself for the long haul. Peace.

@moonboy
How big was the aneurysm?

@tallguy18 No Idea. It burst inside my chest. I never saw or felt it coming until it was there. That's why most people would have a sudden and complete dissection aren't here to tell you about it. @martinkennot and @houston13 are a couple of like dissection survivors as I understand (but then again they may have had elective surgery???). Peace.

@tallguy18 No Idea. It burst inside my chest. I never saw or felt it coming until it was there. That's why most people would have a sudden and complete dissection aren't here to tell you about it. @martinkennot and @houston13 are a couple of like dissection survivors as I understand (but then again they may have had elective surgery???). Peace.