What to do with dilated aaa over age of 83?

Posted by alymat @alymat, Mar 1 11:26am

I keep hearing that aaa surgery is limited to those under a certain age implying that elective repair over the age of 70 is not done, unsafe. I am 83, quit active with only an occasional paroxysmal AFIB episode. Understanding that open heart bypass surgery is necessary for repair, what should I look to if my 5.0 cm aorta keeps expanding? There is an ongoing study of aaa stints at multiple sites. Does anyone have any updates or comments?

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Is your AAA abdominal? Normally that’s what the first A stands for. If it is then you have options, EVAR which is relatively minimally invasive. If it is ascending then the option is OH, and the viability does depend on the person, a thoracic surgeon with an specialized cardiologist would help the patient assess the options.

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Profile picture for houston13 @houston13

Is your AAA abdominal? Normally that’s what the first A stands for. If it is then you have options, EVAR which is relatively minimally invasive. If it is ascending then the option is OH, and the viability does depend on the person, a thoracic surgeon with an specialized cardiologist would help the patient assess the options.

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@houston13 aaa stands for ascending aortic aneurysm thoracic.

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Or abdominal aortic aneurysm

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80's are Not like they were even 10 years ago. You are really in your 60's.
You just have to wait for the medical community to finally get updated on this...and by then their operating techniques will be Safer.
You are in a better position then you think 🙂 (I'm 79 and have plenty of problems too)

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Also to jamiemj: Hey Guys, The "ongoing study of stints" seems to indicate that the aaa is in fact abdominal since stints are not used in ascending thoracic aortic aneurysms. But Alymat, there also is no bypass involved since the repair of the ascending aorta aneurysm is usually repaired with a dacron sleeve sewn in place of the removed aneurysm. But that's all for the doctors to decide. What we need to be concerned with (I'm 89) is how do we get the Hospitals to admit us when the time comes for the procedure. Two hospitals have now not accepted me even for a CT scan,, MRI or Ultrasound. After 18 months since discovery of the aneurysms (ATAA 4.2, Root 4.4) I have finally got a Cardiologist to accept me; only because he moved and is accepting new patients. Jamiemj, what you said is true. Most people (including my doc) said "Are you really 89" when they first meet me. However, no doctor does an aneurysm procedure in his office. The hospitals "RULE" and are protective of their reputation and do not need to add to their cadaver #'s which doesn't look good on their ads.
So, in my case, that seems to be hurdle #1. Bottom line? a major study of 6,000 ATAA patients showed that the overall risk of Aortic Dissection was low and aortic burst was even lower. See (JAMA Cardiology, Vol. 7, Nol11) The findings also found that patients with TAA: earlier preventative surgery should be done only selectively in the nonsyndromic population , given the nontrivial risks associated with aortic surgery.

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The Arise11 study being done at multiple institutions including Stanford, involves a Gore stent being placed through the femoral artery to repair an ascending thoracic aortic aneurysm. Initial selection has been on individuals who would not be surgical candidates. Selection is slow and the study is
To be completed by 2029.

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Profile picture for jamiemj @jamiemj

80's are Not like they were even 10 years ago. You are really in your 60's.
You just have to wait for the medical community to finally get updated on this...and by then their operating techniques will be Safer.
You are in a better position then you think 🙂 (I'm 79 and have plenty of problems too)

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@jamiemj 86 here and have 4.6.Cardiologist said he has many patients with that size.Explained to him that I feel like dead man walking after reading about Drs not wanting to do surgery on our age.Am very active and consider myself in good shape for almost 87.Guess I should stop reading about it!

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Profile picture for dew88 @dew88

Also to jamiemj: Hey Guys, The "ongoing study of stints" seems to indicate that the aaa is in fact abdominal since stints are not used in ascending thoracic aortic aneurysms. But Alymat, there also is no bypass involved since the repair of the ascending aorta aneurysm is usually repaired with a dacron sleeve sewn in place of the removed aneurysm. But that's all for the doctors to decide. What we need to be concerned with (I'm 89) is how do we get the Hospitals to admit us when the time comes for the procedure. Two hospitals have now not accepted me even for a CT scan,, MRI or Ultrasound. After 18 months since discovery of the aneurysms (ATAA 4.2, Root 4.4) I have finally got a Cardiologist to accept me; only because he moved and is accepting new patients. Jamiemj, what you said is true. Most people (including my doc) said "Are you really 89" when they first meet me. However, no doctor does an aneurysm procedure in his office. The hospitals "RULE" and are protective of their reputation and do not need to add to their cadaver #'s which doesn't look good on their ads.
So, in my case, that seems to be hurdle #1. Bottom line? a major study of 6,000 ATAA patients showed that the overall risk of Aortic Dissection was low and aortic burst was even lower. See (JAMA Cardiology, Vol. 7, Nol11) The findings also found that patients with TAA: earlier preventative surgery should be done only selectively in the nonsyndromic population , given the nontrivial risks associated with aortic surgery.

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@dew88
Hi Dew
Thanks for the info...yes its too bad you were too healthy in your younger days (like me) or we would have had our stents and operations earlier...now, we are getting older and the medical community hasn't been progressing in a timely manner with us.
"Elder "discrimination by doctors and hospitals are something this generation may have to have some kind of laws changed for I hope...then minds will be more open..
Good luck be with us both 🙂 (all)

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Profile picture for rockpir @rockpir

@jamiemj 86 here and have 4.6.Cardiologist said he has many patients with that size.Explained to him that I feel like dead man walking after reading about Drs not wanting to do surgery on our age.Am very active and consider myself in good shape for almost 87.Guess I should stop reading about it!

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@rockpir

Yes, they are nonchalant about us old folks aren't they!
Wait until they get here....

As I just mentioned to dew, the medical communities will eventually catch up with our ages...and laws and procedures may be changed about all this.

Good luck to us all 🙂

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Profile picture for houston13 @houston13

Is your AAA abdominal? Normally that’s what the first A stands for. If it is then you have options, EVAR which is relatively minimally invasive. If it is ascending then the option is OH, and the viability does depend on the person, a thoracic surgeon with an specialized cardiologist would help the patient assess the options.

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@houston13 Yes it is Abdominal and the Illiac Artery. Its 1" and I'd like to ask how long have others lived after this procedure?

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