Ascending aortic aneurysm 4.9cm - can I fix my hip first?

It would take his suggestion very serious. That facility has a good reputation regarding aortic aneurysms. I am not familiar with how they do things. For example, at Mayo, there will be a team of doctors giving input with one taking the lead on an actual procedure.

Doc, all I can offer you is that I had an emergent dissection in 2015 at UCSD La Jolla. They saved my life. I gotta believe that the more pressing issue for you is the potential for a sudden dissection. You’re not gonna be able to survive that. If it happens in the middle of hip surgery, so it’s a bit of a catch 22, but knowing what I know about UCSD and the surgery I had I would probably take the aorta off the table first. I know it’s probably not what you wanna hear but the reality is that you know better than anyone how dangerous that aneurysm is.

thank you. That’s another thing I’m struggling with- how to know how good a facility is at a particular procedure. Is there any place that lists procedure volumes and outcomes statistics for different medical centers?

I don't know of a comprehensive set of stats in one place. US-News and World Report does rankings every year based on specialty. UCSD is 27th nationally and top 4 in Cali.
https://health.usnews.com/best-hospitals/rankings/cardiology-and-heart-surgery

thank you! That is reassuring.

I had a video visit with my cardiothoracic surgeon at UCSD yesterday. Good guy! He is aware that I am having considerable pain from my right hip, but nonetheless feels it would be risky to have hip surgery first and recommends addressing the aneurysm before the hip. Since I really can’t delay the hip surgery too much, this would mean, addressing the aneurysm a little early- my aortic root is 4.7 cm and ascending aorta 4.9 cm. The hip pain will complicate my cardiac rehab and somewhat limit my walking. Surgeon is aware. I don’t see that there is really a choice-even if someone else had a different opinion, I don’t think I could be comfortable going against his recommendation. I guess the path is becoming clear….

Hello there! I share your concerns about competing surgery needs. I have ascending aortic aneurysm 5.2cm, mild dilation aortic arch 4.1cm, mild dilation aortic root 3.8cm… This was diagnosed in January when I was already scheduled for a hysterectomy. My gynecologist immediately cancelled the hysterectomy due to concerns about possible complications with the aneurysm.

My aneurysm surgery is scheduled for Oct 2 and will involve partial aortic arch replacement as well as repair of aneurysm possible replacement of root and valve.

In the meantime, and in planning ahead for the aneurysm surgery, I wanted to get surgery for my varicose veins which are severe and cause daily ankle/leg swelling and leg pain/discomfort. I have to wear compression hose to relieve this but I can’t imagine wrestling those socks on after open heart surgery. Plus I don’t wish to have the added leg discomfort when I’m trying to focus on heart surgery recovery. So I thought now is the time to get those veins taken care of. But alas, no, my vascular surgeon said absolutely not! He told me he would look like an idiot if he did vein surgery on me while I have a severely dilated aortic aneurysm.

So my hysterectomy is on hold, my vein surgery is on hold… both must wait for aorta repair first. I feel for you with your hip pain, my goodness. But it seems
the aorta “rules” here, and no doctor wants to risk a potentially very serious complication.

Hi Pattie, thank you for the post! Yes, seems like there is consensus on this.

I can feel for your situation. I have an abdominal aortic aneurysm, and it is at 3.9, but I also need a right hip replacement with 2 bad knees that need to be done also. I was seeing the Orthopedic Doctor, and he told me I was too high risk, therefore, I am getting around on a walker, and in constant pain. I feel I am between a rock and a hard place with all of it, plus I have some other health conditions that are being monitored. I hope you can get the surgery, and start to feel better.