Aneurysm of the ascending aorta

Something to be aware of in aneurysm measurements is that the MRI and Echo measure differently. One measures straight across the aorta and the other measures on the diagonal so will always have a higher number. So we can't compare the two and think our aneurysm size has had a sudden growth spurt.

My ascending aortic aneurysm is at 4.4, which is up from 4.3 two years ago. I expressed concern to my cardio and she said that amount of growth is insignificant. Another cardio described the aneurysm as "small".

I understand that aneurysm repair is a big surgery (and I don't know how long a repair is expected to last). I think unless there is another issue, a well regarded cardio surgeon will not repair the aorta at this size. Watchful waiting seems to be the protocol. I am 78 and am hoping I kick the bucket of some other issue well before I need this surgery.

I understand your concern and your desire to take control of the situation and just get it fixed. But I'm not sure getting it fixed at this stage is my best option. I wish you good health and slow growth to the aneurysm.

Donna

Donna, thanks for your comments. Unfortunately, my ascending aorta grew from 4.4cm to 4.8cm in one year or a 9% which is significant. The initial measurement was done via a CT calcium screening which is now being compared to two echocardiograms. In any event, the MRA (a form of an MRI and performed with the same machine but takes more detailed images of the blood vessels versus the organs or tissue surrounding them) will be done on March 15 and will give me and the surgeon a better idea of the state of the aorta and how to proceed from here.

Good luck with your ascending aortic aneurysm. It's good that it's not dilating rapidly.

I wish you good luck with your MRA and hope the growth measurement is not as severe as it now appears.

Best wishes,
Donna

I too have an aortic ascending aneurysm.
While at a recent emergency room visit for another issue I was informed that my aneurysm had a tear in it and “we are going to have to send you to a trauma center for emergency surgery”.
So once I got to the trauma center they immediately looked at it and said “you are going to have to come back to the hospital for surgery but right now it isn’t bleeding so we feel safe to discharge you and you need to see your cardiovascular surgeon ASAP.”

That surgeon was perturbed that I even bothered going to see him and made light of it during the whole time I was there.

“ is it possible that it could burst?” I said and he said “it could” but after a sonogram he said “see you next year “ and walked away like I was inconveniencing him. He downplayed the whole thing. 2 doctors had scanned it and acknowledged that it was torn and this guy said “see you next year “ Now I don’t trust him.

Hi Andy, Sorry to hear about your experience. Maybe it's best you talk to your primary physician and see what he/she has to say about your aorta. You don't mention how large your aorta is. We really have to advocate for ourselves and learn as much as we can about this condition. Good luck, Tom

You’re right Tom. I don’t even know the size of my tearing aortic aneurysm. How can I find out?
Out of 3 cardiovascular surgeons I never thought to ask the size. Maybe it’s too small for surgery but I would like to know how small or large it is and having a tear in it kind of concerns me.
I have an appointment with my PCP Monday and I will talk with him about this issue. Thanks for responding.
Andy

Hi Andy,
Your PCP should order the right screening test which should be an echocardiogram. That's what I had done but I'm also going to have an MRA done of the chest and abdomen as there is an indication that my abdominal aorta is slightly dilated. My father was operated for an abdominal aneurysm so the issue with me is hereditary. If you saw 3 cardiovascular surgeons and they all are telling you to monitor the tear, then perhaps they all don't see the need to operate at this point. But your PCP should explain all this to you. Good luck, Tom

Ok. Thanks. I will see him Monday and get more information about my situation (if anything). I’m sure he’ll be able to help me.
He tends to send me to my cardiologist for Coumadin monitoring and I suspect he will tell me to see my cardiovascular surgeon. Which really wouldn’t help me because going back to the surgeon that said “see you next year “ is not what I’m looking for as I don’t trust him since he felt annoyed by my presence.
He could have at least send me for an evaluation to inform me how big or small it is.
It’s probably too small to do anything about it but I would like to know the size so that I can find relief in knowing it’s not going to burst anytime soon.
The trauma hospital thought I would have to return for surgery at a later time so I have the right to know why he said that. When a cardiovascular surgeon says I will have to return for surgery just not in an emergency room case that it can wait until later.
Thanks Tom

Hi Andy, one more thing occurs to me that you should do if you haven't already. Check your MyChart to review all notes your cardio surgeons and others posted along with any test results. You should review them carefully since somewhere they have to indicate why you can wait another year. When my PCP saw that my AAA was 4.4cm he said I needed to follow-up in 6 months with a CT scan which showed the AAA grew to 4.75cm. A couple of months after the CT scan I get a call to schedule an appointment with a cardiologist. My PCP had sent a referral to cardiology. I really didn't know why I was referred to the cardiologist until I went into MyChart and reviewed the PCP's notes and test results at which time I had my ah-ha moment - my ascending aorta dilated 8% in 6 months. I recall calling my MD friend asking what he thought about the cardiologist I was referred to since we both know her socially and he recommended her highly but when he asked what I was going in to see her for I said I really don't know. So, you really have to educate and advocate for yourself. Good luck, Tom

That answer he gave you is why I no longer trust many doctors.