@cass57 Hi. My understanding is that those being offered the less invasive repair of an ascending aortic aneurysm (the endovascular stent) are patients who for age or other health issues are thought to be unable to tolerate the full open chest surgery and recovery. There must be reasons why this procedure is not the gold standard for repair but I haven't been able to find that specific discussion in my searches. I do wonder if the endovascular stent repair has a shorter lifespan than the full open chest repair so is offered to older patients who likely won't outlive the repair.

It is possible that during a full open chest repair that the BAV will also be replaced. I know, this is mind boggling to even think about.

My hope is that if I can maintain my current situation that I will live long enough for a new easier procedure to be developed or I will qualify for the endovascular stent repair. My concern is that the aortic valve is leaky and the surgeon will want to replace that at the same surgery and therefore I will be required to have the full open chest surgery. But who knows -- I might be able to avoid any kind of repair and die from something else entirely, at a very advanced age.

In the meantime, I live my life mindful of the recommended limitations on lifting and other exercises or activities that might strain the aneurysm and then I just carry on. Beyond that, I won't let these conditions control me. However, you are significantly younger than I am and if your aneurysm is growing you may be more likely to need this surgery. I suggest you connect with an outstanding vascular surgeon so if the time comes that surgery is recommended, you will have faith in the person advising you and providing your care.

I send you all good wishes.
Donna

Hi @cass57 and others. I've been reading Mayo Clinic comments for 4 months and have found them very helpful; now it's my turn to tell you about my experience and hope you get something from it.

Two years ago my family doctor heard a murmur and sent me for an echo. In those 2 years I had more echos, a stress test, a TEE and a heart cath. (TEE is an echo down the throat) The conclusion was that I had a bicuspid aortic valve (BAV) and an aneurysm on my ascending aorta. The aneurysm was first measured at 4.4, then 4.6 Because I was 67, female, and weighed only 117 pounds, they told me I needed to have surgery.

In those 2 years I went through a whole lot of emotions, I lost sleep - I was also in serious denial (I felt good - I worked out - my blood pressure was good, I ate well. How could I have a problem?) And the thought of open heart surgery was Really Scary. So I did a lot of research and talked to my family.

Bicuspid Aortic Valves are inherited. Two percent of the population is born with a BAV. I found out they show up in my family quite often. BAVs seem to work well until we get older. They are associated with "connective tissue disorder" so that as we age, the tissue doesn't take the stress as well. If you want more information on BAVs (and a better explanation than mine), a really good website is bicuspidfoundation.org. You'll find lots of information on BAVs and aneurysms.

So - after research and serious thought I decided I would have the surgery to repair or replace the BAV and to repair the aneurysm. I knew it would be the full chest incision. I had read many positive comments on these pages from people who had had surgery and were doing well; I also knew about 7 people who had undergone surgery and were walking around today - just fine. (My brother and aunt included.) Those comments encouraged me to have the surgery. I also knew I would go to one of the best hospitals I could. Since I'm from Ohio originally, I went to the Cleveland Clinic.

I called them, got connected and had very good instructions on what to do (I had to get medical records and test results sent to them). I started the process in the fall; I had surgery 4 months later. They assigned me to a wonderful surgeon.

The thought of open heart surgery is very scary. It really makes you review your life and think about who and what is really important. But I felt I was going to one of the best places I could. I put my trust in them and they came through beautifully.

The whole procedure at Cleveland Clinic is very organized - I went up a week early and had tests (CT scan, echo, EKG, lab work, etc). On Monday I had surgery. The surgeon was able to repair the BAV, not replace it. He also repaired the aneurysm. I left the hospital on Friday.

I want to say as far as credit - the surgeon is very important. But - so is the rest of the staff. There is the anesthesiologist, there is the person who opens you and closes you up, the person who puts in all the tubes, people are monitoring your heart rate and other systems. The nurse I had in ICU made me feel so positive that all was well. The whole team is very critical and I thank Cleveland Clinic for being outstanding.

btw, I'm sure Mayo Clinic and other hospitals also do great work. It is important to go to a very good hospital.

As far as recovery, I'm amazed at how well and how fast I have healed. I think a lot of credit goes to Cleveland Clinic. I was also in good shape before the surgery, I eat well, I had very few other problems. I think that helped. Because of COVID19 I have had to skip in person appointments with the doctor - we've had phone calls. I also have not started the cardiac rehab - but hopefully I can get to that next month.

I wish you the best of luck, cass57. It is a hard decision but keep talking to people and do the research. And do know that test results can vary depending on who is interpreting it, and that doctors may have different opinions on how to proceed. Take it all in and hopefully you can come to a good decision (although the virus has changed surgery scheduling).

One last comment - as suggested earlier, I also do meditation. The app Calm is wonderful.
Best of luck to you.