Aortic Aneurysms - 4.5CM - Bicuspid Valve

I'd recommend another scan and/or have a second doc review the earlier echo's. I found my scans on my 'portal' and was able to use their dimension measurement tool to take some measurements of my own and I can attest that you have to be very careful to take measurements in exactly the same manner or your results could be different.

I have a similar situation.
Ascending CT was originally 5.4 and after a second trip to the ER (for issues related to the 7.9 AAA surgery in Feb) they did an Echo and it was 6.08. Just had my second CT scan yesterday and it was now 5.6 after 6 months. Either way I crossed the line for surgery. I was just happy not to have a fourth.

2. Fusiform aneurysmal dilatation of the ascending thoracic aorta measures 5.8 x 5.6 cm , previously 5.7 x 5.3 cm in similar region. 3. Fusiform aneurysmal dilatation of the infrarenal aorta measures up to 4.1 x 3.9 cm, previously 4.0 x 3.8 cm.

This is good to know. I didn't know about the difference between the ECHO and the CT. I hope you get some information that puts your mind at ease.

Met with my cardio today and he also said ECHO is not the total picture He also ordered a chest CTA to evaluate aneurysm.

Dear Fighter
It must be frustrating dealing with those inconsistencies, especially when it comes to something as critical as heart and aneurysm measurements. Variations in scan readings between clinics can be due to several factors, including:
1-Differences in equipment,
-The skill and experience of the technicians,
-The software used for interpreting the scans,
-The protocols followed for the measurements.
To avoid discrepancies; we must eliminate & if possible avoid variation factors as much as possible‼️
Good Luck
Love & Light
♥️🙏🏻♥️

Sorry you are going through this, but welcome to the club. I also have a bicuspid valve and a thoracic ascending aortic aneurysm. I've had yearly echos to monitor until May of this year when cardiologist recommended a CT angiogram and referred me to a cardiac surgeon for consultation. My last echo in Dec 2023 measured aorta at 3.6cm, then in May 2024, radiologist reported aorta at 4.0. But when surgeon reviewed the same CT scan, he measured a range between 4.1 and 4.3. His explanation was that a CT is most accurate for the aorta measurement because of the multiple x-sectional slices they they look at, where an echo is better at looking at the dynamic movement of the blood flow and valve functioning. Also some of the x-sections may be cut obliquely (angled), and not square, which can result in a higher number. It's all very confusing at times. IMO, bottom line, CT should be more accurate and it's best to have the same cardiologist or cardiac surgeon review comparison studies. I will have second CT scan in December to look at rate of growth. I don't think my surgeon plans to go back to an echo for monitoring the aneurysm, but only for the valve which so far is functioning ok. Good luck and keep us posted.

Thank you so much for writing this! I've been trying to find other people with both BAV and aneurysm. Based on what I'm reading it seems like my Dr is ordering the correct tests. Best of luck to you as well.

Please be aware there is a difference between the ascending and descending aorta. Those numbers do not show growth, but rather, a different place in the aorta. Your providers may, in fact, want to evaluate the size of your aorta all the way down to your hips. All the advice on this site apply to you. Keep your BP down and no "bench presses" AND...follow up with your cardiology team regularly. There is no specified size of the aorta that pulls the surgery card unless it grows suddenly or over 8 cm. Different parts of the country and different surgeons have different criteria. I acknowledge that it can be a worry. They followed my ascending aorta of 4.5 for 14 years as it gradually creeped up in size - and I lived my normal life. I had my surgery at age 78 . I was surprised that the sternal incision was not very painful. The challenging thing was the slower than expected recovery of strength. Staying optimistic is the best thing you can do.

Oh, and another issue- the BV. Studies show that the lining of the blood vessels in the aorta can be more prone to aneurysm in individual with BV. However, there are also many who live their entire life with the BV only. As I stated in an earlier post- they often wait to fix the slow growing aneurysm until the BV starts to deteriorate.

Hello Everyone, so Cleveland clinic Cardiologist don't really know as how ECHO can show so much different results then my previous 2 ECO, 1 TEE and 2 CT scans! My highest to-date result is 4.6CM through CT in June 2024 so having this to grow from 4.6CM to 5.3CM in 2 months is puzzling.

I am going for my CT scan tonight and will see, what is right and wrong but will post to this group to let everyone know so if someone in the same boat, can at least have some reference and guidance unlike me.

Thank you all.