Aorta: dilated vs aneurysm?

Posted by earlthepearl @earlthepearl, Aug 31 4:43pm

In 2007 via CT my ascending aorta was 4.8 cm, 4.8 in 2011 then it was 4.4 cm in 2013, 2015, and 2018. It was 4.7 cm in 2020 and 5.0 in 2021 and the descending was 3.4 cm at the RPA level.
My AoD measured by Echocardiogram was 4.4 cm in 2004, 4.2 in 4012, 4.1 in 2018 and 3.8 in 2021. My age is 81. My Cardiologist, nor a heart surgeon he recommended that I talk to, were for anything more than watch and wait. Next annual CT will probably be in Oct .
Am I on a reasonable path?
My AoD as measured

Interested in more discussions like this? Go to the Aortic Aneurysms group.

In 2011, I had an Abdominal Aortic Aneurysm that took 7 years to expand and have a stent placed inside me. Everything is still fine and as I read your post, it made me think of something. I’m 79 but that 7 year wait was so stressful, my blood pressure was high so I was give medicine to lower it. So looking at your numbers, I wonder if a life style change by you kept your blood pressure low. Then as time passes, you aged, your blood vessels aged and your blood pressure changed. An Aneurysm must be 5cm before Medicare or insurances will pay to repair it. Since it fluctuates, they may wait till it stays at 5cm before they operate. That sounds logical to me, just don’t get overly excited, remember, the higher your blood pressure goes up, it expands the aneurysm in and out with each heartbeat.

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@earlthepearl
Hello – Welcome to Mayo Connect, where we are a group of people living with all the conditions and diseases life sends our way. We try to encourage one another along the way, but we are not pros, so we don't try to diagnose or treat one another.
It is really great that you are being closely watched – the key in many situations is that stable is okay, rapid change is bad. I am assuming that your team has also taken steps to keep your blood pressure under tight control as well. sounds like you and your doctors are on a reasonable path – a lot of medical care falls into just such a plan as yours "watch and wait." The things docs look at, besides the actual size at the time of measurement, is a pattern of accelerating growth, your physical ability to handle the surgery, and any other health issues that might make surgery inadvisable.

If you are comfortable with your care team, I think you can safely take a deep breath and relax – you do not seem to be showing any pattern of rapid growth.
How do you feel about this path?
Sue

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My husband's ascending aortic aneurysm varies depending on who measures it and what "points" they use to measure. It looks like that could be the case for you also.
When my husband's Mayo cardiothoracic surgeon measures it, he comes up with 4.6 cm. When the radiologist measures it, the value is 4.8; the echocardiograph reader says 5.1.
These are all done at Mayo Rochester looking at the same tests.
This surgeon pointed out that a lot depends on the "measurement points." You need to know what those points were in measuring your aneurysms. You may be on the cusp of needing surgery or surgery may not be in your future for years. I don't know but I sure would ask questions.
In reading some literature from the Cleveland Clinic, ascending aneurysms grow at .07 cm a year. My husband is 78. I asked when he would be too old to do a repair surgery. His surgeon said 85-86 depending on his physical health. He keeps his blood pressure low (below 120/80) and does not lift anything over 30 lbs.
My husband has a lipid abnormality (lp(a)) which means even though he keeps his total cholesterol very very low and all the lipid values are stellar, he still has a problem with atherogenesis.

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@sueinmn

@earlthepearl
Hello – Welcome to Mayo Connect, where we are a group of people living with all the conditions and diseases life sends our way. We try to encourage one another along the way, but we are not pros, so we don't try to diagnose or treat one another.
It is really great that you are being closely watched – the key in many situations is that stable is okay, rapid change is bad. I am assuming that your team has also taken steps to keep your blood pressure under tight control as well. sounds like you and your doctors are on a reasonable path – a lot of medical care falls into just such a plan as yours "watch and wait." The things docs look at, besides the actual size at the time of measurement, is a pattern of accelerating growth, your physical ability to handle the surgery, and any other health issues that might make surgery inadvisable.

If you are comfortable with your care team, I think you can safely take a deep breath and relax – you do not seem to be showing any pattern of rapid growth.
How do you feel about this path?
Sue

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Thanks for your reply. I am glad that after all these years I stumbled upon this site.

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