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5.2 ascending aortic aneurysm- waiting for surgery (?)
72YO male: I’ve had a St Jude replacement aortic valve since 1998 that leaks a bit with my left ventricle enlarged to 7cm. I also have a slowly enlarging ascending aortic aneurysm, 5.0 to 5.2cm and my current plan is to wait for open heart surgery to replace my aortic valve and fix my aneurysm when it reaches 5.5cm. I’m slightly worried about waiting because I won’t be as “healthy “ for surgery in my late 70s as now. Any ideas concerning putting surgery off until necessary or solving problem now?
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At 5.4cm you are thinking correctly, but you also need to think about timing. You are willing to travel to get the best care but that is probably something you need to settle very quickly, as @pamela78 says you don't want this to become an emergency as you won't be able to travel in that case. Planning for the best possible care is awesome but you should have a contingency in case of an unexpected event (read @moonboy's comment above), in an emergency you need to be minutes from an operating room.
Just in case mine was done at Memorial Hermann Texas Medical Center in Houston, by Dr Anthony Estrera (probably the best in Houston).
How far away are you? If you can't fly, you are basically talking about driving or maybe if you are lucky going by train. It is 180 miles one way for me to go to Mayo. I realize that isn't far compared to some people's situation.
You are smart about being willing to travel. Again, high Volume centers provide the best chance of a great outcome. Also ask about retrograde perfusion to the brain. Different surgeons within a practice may do it while others will not. (Cognitive issues are among the most important to us.) The Cleveland Clinic in Cleveland Ohio and the Mayo Clinic in Rochester MN both have high volume good programs. Houston Methodist is another that publishes about innovative approaches. I am certain there are others on the East and West Coast.
We go to Mayo and are very happy. My aneurysm is at 5 but I don’t have vasculitis or other high risk “features.” It is stable and Mayo advised I could come back in 2 or 3 years but I want annual exams.
Good luck to you.
Yes - 180 miles is not far. I travel 1350 miles one way to go to Mayo. We have been going there for 30 years and we trust Mayo.
I live in the middle of NC. Since I'm from the Midwest, I'd probably prefer Cleveland Clinic or Mayo, but getting there would be an ordeal any way you slice it.
If I went out of state, Cleveland Clinic in Cleveland was #1 on my list.