Dilated Aortic root

From what I understand, one would have to be a candidate for the minimal invasive surgery. I'm sure it leaves most patients out of that picture. I've reached 80 years and my diagnosis was three years ago in November. My readings range anywhere from 4.2 to 5.1 with a recent MRA and an Echo. One cardiac surgeon is reading me at 4.2 while my cardiologist and cardiac nurses and radiologists are reading me at 5.1. Talk about sleeping well at night???

Hi,
I was diagnoised in Decemebr of 2023. At that time a cardilogist read my dialiation at 4.9 with an echocardiogram I'm getting varied dilatation growth rates anywhere from 4.6 with a Gated CT scan (April 24) to a 5.1 with a recent (May 24) echocardiogram. Also getting conflicted reports on which test is more accurate for the aortic root measurment. One surgeon say the CT scan is the best and another claims the Echo is better??? I went for another CT scan just the other day but the radiologist opted out due to the dye needed and my only having one kidney. I'll confer with the surgeon this week. I've seen several cardiologist and two surgeons at this point, again, with conflicting views on the more accurate test. At this point it's check with CT scan every 6 months.

CT scans give out a lot of radiation. I only have MRIs. Request an MRI and see if your doctor will write an order. Regarding accuracy, it is my understanding ECHOs aren’t as accurate for measurements as CT scans and MRIs.

I was also diagnosed in December '23. I have never had any symptoms. My aneurysm was found in a checkup with my general practitioner after my 65 yr old brother died suddenly from an unexpected heart attack or aortic dissection. We don't know for sure because the autopsy that I had requested wasn't done. In December '23 my CT scan showed an ascending aortic dilation of 4.2, but missed an aortic root aneurysm. My echocardiogram that same day measured my ascending aorta dilation at 4.3, and found my aortic root aneurysm at 4.5. I was referred to a cardiologist in town for further testing and I got an echo from him in February that measured my ascending aorta at 4.1 and my Aortic root at 4.2. I got into Mayo in March, and my cardiologist there didn't like and was confused by the February echo and so I had another that day and it measured my ascending aorta at 4.2 and my aortic root at 4.7. For a number of reasons, he referred me to their congenital aorta specialist who did a Ct Scan with contrast that showed my ascending aorta at 4.1 and my aortic root at 4.8. I'm meeting with a geneticist at Mayo next month, and the congenital aorta specialist says that if DNA testing finds a genetic marker for this, she would recommend I look at surgery options now with the 4.8 measurement because genetically caused aneurysms are more dangerous sooner. If no marker is found she recommends that I get an echocardiagram one time per year, and to evaluate surgical options once the aortic root reaches 5.0. I am so glad I was able to get into the Mayo system. There are handful of hospital systems that are world class for aorta issues - and I would highly recommend you make sure that yours is one of them. Best of luck to you on this journey!

Hi,
I was diagnoised in Decemebr of 2023. At that time a cardilogist read my dialiation at 4.9 with an echocardiogram I'm getting varied dilatation growth rates anywhere from 4.6 with a Gated CT scan (April 24) to a 5.1 with a recent (May 24) echocardiogram. Also getting conflicted reports on which test is more accurate for the aortic root measurment. One surgeon say the CT scan is the best and another claims the Echo is better??? I went for another CT scan just the other day but the radiologist opted out due to the dye needed and my only having one kidney. I'll confer with the surgeon this week. I've seen several cardiologist and two surgeons at this point, again, with conflicting views on the more accurate test. At this point it's check with CT scan every 6 months.

@geocirese
I worked in cardiac echo and cath labs for over a decade. I ran an imaging training program. Measurements are somewhat in the eye of the beholder. First, consistency of imaging mode is important. Compare echo to echo or CT to CT for growth rate. Second, I go to the same place with same machine if possible. Third, no blood vessel is absolutely uniform in size and contour. So if you measure a little bit higher up or lower down on the vessel you may get some variation. Also if you have 3 people measure the same image you may get slight differences in each measurement. If you measure at the peak flow of a ventricular contraction it may be a mm more than in diastole (hence gating to the ekg helps comparative accuracy). I personally trust echo with a good tech more because they can move around and make sure they are getting the best perpendicular slice when they measure and can scan up and down the entire length so you see a more complete set of pictures - not just a single shot.
Bottom line - all measurements have a range of accuracy and error. So consistency - if one echo shows 4.2 and six months later shows 4.1 or 4.3 - in my mind no significant difference. For me - measure in the same modality for best comparisons. Also of note - dye studies light up inner diameter and echo and non-contrast show walls, inner and outer diameter - therefore another source of difference - again, compare only same modality in my world.