Ascending Aortic Dilation - Ascending Aortic Aneurysm

Posted by rory @rory, Apr 2, 2018

I was diagnosed in 2012 with ascending aorta dialation of 4.1 cm. In 2013 no change. Finally went back to dr in 2017 and echo showed 4.3 cm. 2 months later dr made me have a chest scan which read 4.5 cm. which is correct? Echo or scan? Dr wants me to have another in 6 months. Very stressful.

Hello All

I am 31/M
I had my bicuspid aortic valve replaced 8 years back with ATS Mechanical 22 Mm valve.
Now I am diagnosed with ascending aorta size of 5.2 and aortic root of 4.4.
I talked to 2 surgeons in diff hospital.
One surgeon says that no need to replace well functioning mechanical valve and will cut root just before the valve and cover the little rim and existing valve with graft.he gives reason if a mechnical valve passes 1 year successfully it typical remain forever and should not be changed. His recommendations is not to touch the place where valve is sewn to root.

Other surgeon is of opinion that when we will open we will be able to see the condition of root and if it need to be replaced we will put new composite graft already fitted with a new St.Jude valve.
He also believe my current valve is 100 percent functioning but as per him existing valve should have some tissues deposited and replacing a new is always better.

What to choose. Both surgeon are top notch surgeon in diff hospitals

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@dixitworld

My current surgeon are Craig Miller at Stanford and Dr Svensson at Cleveland Clinic. What I understand is more surgeon in diff hospital I talk more diff opinion comes up resulting in more tension and headache. I was looking for any patient similar in condition like me who can tell what was done in his or her case

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Thank you for providing additional information and details about your medical history, @dixitworld. I hope that others will be able to post and offer their own experiences. Do you have any family members or friends that can listen to your choices (or go with you to appointments) and help you discuss your concerns?

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quit the stress. only can make it worse. Do work outs, bike, no heavy lifting over 50 pounds, keep BP under control and realize that you know what may give you problems in future. Most people do not. Mine is 4.7, wet to cleveland clinic, dr told me i have 10 more years. What ever. live your life and quit worrying.

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@bryanfox

I was diagnosed in August 2019 with an ascending aortic aneurysm, measured at 4.2-4.3cm via CT scan and confirmed by a vascular surgeon and two cardiologists. Last week, I went back to recheck and see if there had been any growth. I opted for an MRA to avoid the radiation, and because the cardiologist said it would provide the same accuracy. The imaging showed that the aneurysm was/is now 3.9cm, which is great news, but also somewhat implausible, because everything I've read and heard from doctors is that these do not shrink on their own. I did start medication for hypertension after the initial diagnosis (olmesartan) last year, and my BP is now normal, but it wasn't dangerously high before (peaking at 140/90 last year). That's the only medication I am on, and there haven't been any other major lifestyle changes.

Is there a possible reason for this disparity in imaging results? I'm cautiously optimistic, but also confused.

Thanks

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Hi, I think you are right about the aneurysm not shrinking. However, the measurements you have had are all pretty close and the different tests and different technicians can result in different numbers. The most important factor is to determine if the aneurysm is growing and if so, at what rate. My ascending aortic aneurysm has been at about 3.9 – 4.1, depending on the test, for years and years. I am hopeful I will never need surgery. The aneurysm no longer controls my life but I am careful about what kind of exercise I do and how much I lift. I too have high blood pressure, controlled with meds. I wish you good health and a stable aneurysm.

Donna

Liked by bryanfox

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I was diagnosed in August 2019 with an ascending aortic aneurysm, measured at 4.2-4.3cm via CT scan and confirmed by a vascular surgeon and two cardiologists. Last week, I went back to recheck and see if there had been any growth. I opted for an MRA to avoid the radiation, and because the cardiologist said it would provide the same accuracy. The imaging showed that the aneurysm was/is now 3.9cm, which is great news, but also somewhat implausible, because everything I've read and heard from doctors is that these do not shrink on their own. I did start medication for hypertension after the initial diagnosis (olmesartan) last year, and my BP is now normal, but it wasn't dangerously high before (peaking at 140/90 last year). That's the only medication I am on, and there haven't been any other major lifestyle changes.

Is there a possible reason for this disparity in imaging results? I'm cautiously optimistic, but also confused.

Thanks

Liked by degarden_girl

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@bryanfox

I was diagnosed in August 2019 with an ascending aortic aneurysm, measured at 4.2-4.3cm via CT scan and confirmed by a vascular surgeon and two cardiologists. Last week, I went back to recheck and see if there had been any growth. I opted for an MRA to avoid the radiation, and because the cardiologist said it would provide the same accuracy. The imaging showed that the aneurysm was/is now 3.9cm, which is great news, but also somewhat implausible, because everything I've read and heard from doctors is that these do not shrink on their own. I did start medication for hypertension after the initial diagnosis (olmesartan) last year, and my BP is now normal, but it wasn't dangerously high before (peaking at 140/90 last year). That's the only medication I am on, and there haven't been any other major lifestyle changes.

Is there a possible reason for this disparity in imaging results? I'm cautiously optimistic, but also confused.

Thanks

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Hi, @bryanfox – I wanted to let you know I have moved your post here to this discussion called "Ascending Aortic Dilation – Ascending Aortic Aneurysm" so that you can talk with others who have had a similar situation. Hoping that @cobweb @hopeful33250 @dixitworld @rory and others will return to this discussion to respond to your question about MRA vs. CT scan in measuring ascending aortic aneurysm.

Have you gotten the chance to ask your doctor specifically what he or she thinks about the disparity in your imaging results?

Liked by bryanfox

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@lisalucier

Hi, @bryanfox – I wanted to let you know I have moved your post here to this discussion called "Ascending Aortic Dilation – Ascending Aortic Aneurysm" so that you can talk with others who have had a similar situation. Hoping that @cobweb @hopeful33250 @dixitworld @rory and others will return to this discussion to respond to your question about MRA vs. CT scan in measuring ascending aortic aneurysm.

Have you gotten the chance to ask your doctor specifically what he or she thinks about the disparity in your imaging results?

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Yes, he said that it's within the "margin of error" and to just come back in a year to do a re-scan, which again, seems to be good news, but perhaps TOO good, which is why I made the original post. Thanks

Liked by Lisa Lucier

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Relax, stress hurts you. Exercise, but no heavy lifting of weights. Keep your bp down. If you stress out, it hurts you. I have asked my Drs a lot of questions. I also went to the Cleveland Clinic. Get on the net. There are great interviews on line with Cleveland Clinc drs and mayo drs. Good luck. BY the way my size is 4.7/

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@mariejnd

Hi Alyse,
Thank you so much for replying.  I do have another question.  You asked whether I have researched any doctors.  I have not done so because I don’t know a reliable and credible route to take for the research.  Any suggestions?   I live  In the Minneapolis, MN area therefore the Mayo Clinic in Rochester is convenient for me. 
Thank you, again.

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Hi Marie,
I had a triple A surgery done at Abbott Heart 4 years ago. Everything went good. I went in this last week because I had a cat scan of lungs. They said I had two aneurism. I went back to my vascular surgeon at Abbott he did a scan and read their scan and saw things very different then the other radiologist. I think Abbot's heart is the best. I had one anerisim 3.7 no dilation. He is very good, but, he is retiring. He is contacting me with the name of another vascular surgeon at Abbott to keep watch on me. Have to go in.once a year for recheck. I am 76. Hope this helps. Abbott is much closer then Mayo. Good luck. My thoughts are with you.

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@paulj

Hi,
I have a ascending aortic aneurysm that is 5.1 cm. it was diagnosed in June of 2011. I have been told that at this time it will be treated with medications but if it grows to 5.5 cm then a surgery will be performed.Also one doctor says if it moves to 5.3 between ct or mri s then i would be a candidate for surgery. Being a typical guy i feel that if its this close why don t we just fix it! I am typicaly very active and this just seems like were playing with fire…. I know percentages,etc etc but if it bursts I am told I will most likely die before the ambulance arrives or at best a 50 percent rate of survival if i make it to the hospital.
What a crazy way to live.
I am leaving for 5 weeks wandering around Costa Rica with a backpack and my rental car so hopefully all will be fine. I would like to do the Camiino de Santiago 550 mile walk through France and Spain carrying a backpack this fall….but what the hel??,,,l is this safe???? i have been going to the V.A. (Veterans Administration) since I don’t have regular health insurance….I just can’t afford it…I am told the Mayo Clinic might take on my case as a “pro bono” situation and help me live….
It’s such a strange feeling to know you can drop dead at any time due to a particular condition that everybody is aware of but waiting for a Fix that is already there and I believe well proven….If the surgery is available but .2cm is what i need to qualify…wher e are those administrators that determined this 5.3 or 5.5 cm threshold if I am out ther and it bursts?
Well, this was a lot of rambling but maybe theres a Doctor or Mayo clinic or someone out there that can help….
Please pass this on to anyone at mayo Clinic that you think can help..
In the meantime I will continue to take my meds and walk through life as best i can…
I know we are all going to die and it could happen at any time but seems a little strange.
I feel like if my engine on my car was acting strange and i took it in and they said it needs to be rebuilt and it will take care of the problem ..otherwise put this of oil additive in it and drive to New York..you should be fine…oh and if it breaks down in the rockies …you’ll probably never get parts so you wont make it to your daughters wedding on time but probably never…..
so put this can of oil additive in and lets all wish for the best?
Have a great day,,,this was fun to vent…hope somebody else reads this and relates or maybe just gets a good laugh…
(maybe an aortic surgeon over at Mayo Clinic
Paul

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I hope you made it to Costa Rica! I empathize with you! We all are in the same crazy boat! I think it is because the risk of surgery has its percentages, and the percentage of yours bursting at your level- perhaps it’s less percentage than surgery? I don’t know.I am now on Medicare with an advantage plan . Perhaps you should look into what Mayo can do for you. It’s sinful that we must turn to go fund me on Facebook or something or other for our survival.

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@elsinann

Hi! Thank you for asking. And no, you’re not ignorant!
I’m not a candidate for surgery because I have a second aneurysm, of my heart wall; a paralyzed hemidiaphragm; my lung capacity is 40% of normal; my one kidney doesn’t have a decent artery to it, so I can’t get dialysis; there is PVD; two mini-strokes, my “tissues are weak”; ventral hernia; my spleen was removed. Four doctors, including two surgeons and my pulmonary doctor, told me that I’m not a candidate for surgery.
On the OTHER hand, I’m a writer, have much curiosity about the world, enjoy NCIS and other TV shows, love to read, have a great family (who live far away, unfortunately); am enjoying (and feeling ashamed about my enjoyment) presidential politics this year.
In other words, life is good!
Annie Perry
(Elsin Ann Perry)

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You are enjoying life- never be apologetic of your curiosity. Love is your answer- it is eternal. Keep each day as an expansion to love even more.

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@lisalucier

Hi, @bryanfox – I wanted to let you know I have moved your post here to this discussion called "Ascending Aortic Dilation – Ascending Aortic Aneurysm" so that you can talk with others who have had a similar situation. Hoping that @cobweb @hopeful33250 @dixitworld @rory and others will return to this discussion to respond to your question about MRA vs. CT scan in measuring ascending aortic aneurysm.

Have you gotten the chance to ask your doctor specifically what he or she thinks about the disparity in your imaging results?

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Hello, @lisalucier Here we are in April. Not sure how this post works yet. I am new. Reading some posted here. Interesting. They found a 4.8 Ascending aneurysm with bicuspid valve last August. I have never had and issue and in pretty good shape at 57. I was working out everyday. Hikingquite a bit and other activities. Now down to zero and depressed. The echo test should 5cm, the CT scan showed up at 4.8 and the latest CT scan showed up at 4.95. Am I coming or going? Can this grow that fast? Another scan is set up for August or September. I have no idea what to think of this. I am told operation with be needed before 5.5cm. Is this factual? They can't even tell me the exact size. How does this work? And quite frankly, Anyway, to say this is a nightmare is an understatement. Any feedback out there?

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Hello,
Once you get the Bicuspid Valve(I'm assuming the Aortic Position) replaced you will have so much more energy. At 50 mine was all stiffened and not opening or closing completely. They called this condition Stenosis. Ask your Doctors about the condition status of the valve. I had and Aneurysm too but when that happened and needed surgery there was no time to do the valve. They did the valve 10 years later. I bet with you they will probably do both at the same time.

Stay well.

Bruce S.
Texas

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@ch246cf10

Hello,
Once you get the Bicuspid Valve(I'm assuming the Aortic Position) replaced you will have so much more energy. At 50 mine was all stiffened and not opening or closing completely. They called this condition Stenosis. Ask your Doctors about the condition status of the valve. I had and Aneurysm too but when that happened and needed surgery there was no time to do the valve. They did the valve 10 years later. I bet with you they will probably do both at the same time.

Stay well.

Bruce S.
Texas

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Indeed aortic valve bicuspid. They will do both at the same time. I have no issue with the valve, it is in good working condition. But they will try to repair it. At this time I have no lack of energy. I am a fitness buff. Its like i have no issues. Its more in the mental aspect. I just question how they are getting so different measurements. I live in Canada, operation options are limited. I am hoping to find a mini sternotomy operation vs, full sternotmy. I will be asking Cleveland Clinic for their opinion and see if they are my choice. Happy you are well and energenic.

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@cass57

Hello, @lisalucier Here we are in April. Not sure how this post works yet. I am new. Reading some posted here. Interesting. They found a 4.8 Ascending aneurysm with bicuspid valve last August. I have never had and issue and in pretty good shape at 57. I was working out everyday. Hikingquite a bit and other activities. Now down to zero and depressed. The echo test should 5cm, the CT scan showed up at 4.8 and the latest CT scan showed up at 4.95. Am I coming or going? Can this grow that fast? Another scan is set up for August or September. I have no idea what to think of this. I am told operation with be needed before 5.5cm. Is this factual? They can't even tell me the exact size. How does this work? And quite frankly, Anyway, to say this is a nightmare is an understatement. Any feedback out there?

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Hi. Don't panic about the slightly different measurements of the aneurysm. CT scans and Echos measure differently and the technician doing the scan can read it differently. My cardio tells me that such a small difference is actually insignificant.

I can understand your shock and dismay at this diagnosis. I remember when I was told I had one which was about 13 years ago. It is easy to feel depressed and very vulnerable. Not sure why you stopped exercising — was this your Cardio's recommendation? For me, I was told to not lift more than 25 lbs., not to shovel snow (see, there is a good side to everything!) and to assure I can carry on a conversation when doing aerobic exercising. So, in 13 years, my aneurysm has gone from 3.8 to 4.1. It is slow growing and I am hopeful that I will die from old age rather than from the aneurysm. I'm 75 now so that is a distinct possibility.

So, try to see this as a health issue that needs to be managed, not a death sentence or even a cause for surgery. I suggest you talk to your cardio to determine if you can continue exercising as that might help lift your depression.

I wish you good health.

Donna

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