Aortic Aneurysms – Introduce yourself & meet others

The surgical threshold for ascending aortic aneurysms can vary based on several factors, including the type of aortic valve, the patient’s overall health, and the presence of symptoms. In patients with a bicuspid aortic valve, the threshold for surgical intervention is often set at 5.0 cm due to a higher risk of complications such as rupture or dissection. However, in patients with a trileaflet aortic valve, the risk profile can differ, potentially allowing for a higher threshold of 5.5 to 6.0 cm before surgery is considered.

Your cardiologist’s recommendation of a 6.0 cm threshold is based on your specific condition and the presence of a trileaflet valve, which typically has a different risk profile compared to a bicuspid valve. The larger threshold takes into account your good overall health, controlled blood pressure, and lack of other health concerns. This approach aims to balance the benefits of delaying surgery with the risks associated with the aneurysm’s growth.

While it may not be as commonly discussed, there is medical literature supporting the higher threshold for patients with trileaflet valves. The goal is to avoid the risks and complications of surgery until it is absolutely necessary, given the slower growth rate and lower rupture risk associated with these conditions in some patients.

It’s understandable to feel anxious about this diagnosis and the varying thresholds. It’s important to have regular follow-ups with your cardiologist, including imaging studies like echocardiograms or CT scans, to monitor the size and growth rate of the aneurysm. This proactive approach ensures timely intervention if needed.

• Lifestyle: Continue maintaining an active lifestyle, as physical fitness contributes to overall cardiovascular health.
• Medications: Adhere strictly to your prescribed medications for blood pressure and cholesterol management.
• Monitoring: Schedule regular check-ups and imaging studies to track any changes in the size of your aneurysm.

Your cardiologist’s advice appears to be well-founded, considering your individual health profile and the nature of your aortic valve. It is not uncommon for patients with a trileaflet valve to have a higher surgical threshold. Staying informed and maintaining open communication with your healthcare team is essential for managing your condition effectively. His prediction that you will outlive this aneurysm is well placed. Peace.

I am a 77 yr old female, just diagnosed with a 4.3 TAA, ascending. I am in good health, controlled BP with meds, Good cholesterol, triglycerides, very active with
no other health concerns, no previous surgeries.
My question is after my cardiologist consultation, he said because I have a 3 leaflet valve vs. A 2 leaflet (bicuspid) valve my surgical threshold was 6.0, not the most common 5.0 cm.
He was implying I had much more room for growth & would probably die with this ever reaching that point of surgery. I had not heard of this 6.0 cm measurement as common before, after researching intently.
Has anyone with similar circumstances received this prediction? My inclination was he is trying to settle my anxiety.
Thank you for any input concerning 6cm VS 5cm.

I have a three leaflet valve as well. I never even heart of such a thing until about two weeks ago. I also have a Bovine heart. I didn't know I was in such strange shape. (I'm 78) My blood pressure was well-controlled with meds. and my cholesterol has always been good, but ever since getting this diagnosis my b.p. has spiked. I have some family issues that are ongoing so my stress level is on the high side, though I don't really feel anything physically. I didn't know about the 6.0 threshold for 3-leaflet valve. To be quite honest, I'm getting more information from this group than from my doctor. I like him a lot but I'm learning there's a lot more to this than I've been told. When I asked him if I'd be okay, he said, "Probably." It takes some getting used to having a serious diagnosis that can only ultimately be resolved with open-heart surgery.

I have a three leaflet valve as well. I never even heart of such a thing until about two weeks ago. I also have a Bovine heart. I didn't know I was in such strange shape. (I'm 78) My blood pressure was well-controlled with meds. and my cholesterol has always been good, but ever since getting this diagnosis my b.p. has spiked. I have some family issues that are ongoing so my stress level is on the high side, though I don't really feel anything physically. I didn't know about the 6.0 threshold for 3-leaflet valve. To be quite honest, I'm getting more information from this group than from my doctor. I like him a lot but I'm learning there's a lot more to this than I've been told. When I asked him if I'd be okay, he said, "Probably." It takes some getting used to having a serious diagnosis that can only ultimately be resolved with open-heart surgery.

I have a three leaflet valve as well. I never even heart of such a thing until about two weeks ago. I also have a Bovine heart. I didn't know I was in such strange shape. (I'm 78) My blood pressure was well-controlled with meds. and my cholesterol has always been good, but ever since getting this diagnosis my b.p. has spiked. I have some family issues that are ongoing so my stress level is on the high side, though I don't really feel anything physically. I didn't know about the 6.0 threshold for 3-leaflet valve. To be quite honest, I'm getting more information from this group than from my doctor. I like him a lot but I'm learning there's a lot more to this than I've been told. When I asked him if I'd be okay, he said, "Probably." It takes some getting used to having a serious diagnosis that can only ultimately be resolved with open-heart surgery.

You might want to check out the American heart association guidelines for aortic aneurysms. I think it can be googled. They came out updated in 2022? I think they lowered the size to 5.5 for surgery for a three leaflet valve which is the normal configuration a two leaflet valve is more likely to have issues and so they, do surgery sooner I think at 5.0 I looked at and it was very helpful. Someone also on here told me about square breathing, where you breathing through your nose 4 seconds, hold it four seconds and breeze out through your mouth for four seconds… It takes you out of fighter flight and put you into rest and digest. In other words, it tricks your body into thinking your calm and your blood pressure is rising because of stress it will go back down I feel that really helpful because when I first was diagnosed that was terrified, but I am at peace now and my 4.2 cm aneurysm has remained stable for the last year and a few months

This is very helpful. Thank you. I'm 78 with a 4.2 and a Bovine heart. I'm glad to know about the breathing thing as my b.p. has been way higher than usual.

Hey I have this so called bovine arch too , along with a bicupsic valve . My ascending aneurysm is 4.4 . I go for another ct in the new year. The arch thing I know is weird , but I guess it does happen . I think it’s important for surgery as to know where things are.