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Early surgery: Can I get aortic aneurysm repair before it's 5.0?
I have a 4.1 ascending aortic aneurysm, and my local cardiologist tells me what every other one tells me, including Cleveland Clinic and Mayo. No surgery considered until 5.0, if valves are in good shape (mine are, except for 5% regurgitation).
The rationale offered for waiting: the risk of the surgery is greater than the risk of an event resulting from the aneurysm before it reaches 5.0. Meanwhile, I am told to limit myself to moderate exercise and to take drugs, in hopes of slowing growth of aneurysm.
I will be 71 next month, in good health, and very active. I am more interested in getting the repair done now so that I can resume a full life, rather than waiting around until I get feeble and less likely to have a good result when they eventually open me up for repair. I am much more willing to accept the risk of the surgery now than I will be 10 years down the road. I know, I know--it might never even require surgery--in which case, I can continue my life of "moderate exercise" until my number is finally up. Not interested.
Does anyone know a top surgeon who is willing to talk with me about getting this done now or in the near future?
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The specialist at a university hospital out of state who has done many of these operations and is following my case has told me the surgery is done once it leaches 5.0 cm He now measures my scan at 4.5 cm and I am on annual scans. I am also followed by a local cardiologist and he and local radiologist measure my scan at 4.2. So measurements are not exact and vary depend on who is measuring. They both told me that the chances of fatality when under 5.0 cm is extremely low where surgery can have a chance of a few percent. So they do not operate under 5 cm because of that unless they measure a rapid rate of increase. Very frustrating since I now have this for 3 1/2 years and losing on 71 years old.
Don't give up and continue trying to exercise however you can. Have you tried other machines like an elliptical stair stepper? They have support rails around you on 3 sides.
My ascending aortic aneurysm was discovered about 10 years ago when I had a chest X-Ray for lung cancer (I didn't have it) and back then it was 4.something. My GP sent me to a cardiologist who started having me get annual CT scans. It grew and when I hit (high) 4.something he referred me to a surgeon. In 2023 it measured 4.9 X 5.1 but in 2024 it measured 5.1 x 5.5 and the surgeon said it needed fixed sooner than later. His major concern was my age (80) but said he took into consideration that I wasn't over weight and jogged a mile several times a week. A heart cath said I didn't need bypass surgery. I had the surgery including aortic root and bovine valve replacement. Per pre-surgery conversation, I expected to go home in 7-10 days. Each day when the surgeon came to visit he said no, not yet, they wanted to get the A-Fib under control, something I didn't have before surgery. On the 10th day my pulse got down to 30 something and I passed out. They revived me but a couple of hours later my hear completely flatlined and I had to be revived with paddles. I am eternally grateful I didn't get to go home on the 10th day! I had a temporary pacemaker installed that afternoon and a "permanent" one installed the next day. I remained in the hospital for 5 more days then went home. It's been 6 months since but I regret to say I'm not back to anything like "normal" though getting better. A month plus after I came home I went to a car show and ended up spending virtually the whole time in a wheel chair. I still tire easily, sleep too much, have passed out a couple of times - once on the stairs - and been very dizzy a few times. I did the whole regimen of cardio rehab at the hospital and have since been going to a local gym to continue the same exercise - pedaling a bicycle-looking machine for 45 minutes on resistance 8. I've wanted to use a treadmill since I still stagger and find walking a distance a problem. I get "no" for an answer because of my "unsteady" walking and potential injury on the machine. I'm reminded of my age and that I'm doing well "considering". My brother is 7 years older and following my advice had a chest X-Ray only to find out he has the same thing though not quite as advanced. He has been told he's too old to risk it and considering his overall health I'd agree.
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4 ReactionsThis is a question you should be asking a good cardiologist and surgeon about.
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3 ReactionsI have a 5cm aorta aneurism grown from recent 4.8
A aortic artifical valve since 1990 34 years old
Been leaking,they say not much
Living with heavy breathing and exhaustion
People tell me to turn my head because i breathe so hard
72 years old
Should i have surgery or wait
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1 ReactionThere are abdominal aneurysms, but this thread is referring to aortic aneurysms. I believe that they both can be viewed via ultrasound.
Thank you for your reply.
I thought there were also abdominal aneurysms, in which case the aneurysms wouldn't show on echocardiograms (not true?).
Start with an echocardiogram first. It should identify an aneurysm if present and well as any valve issues. Insurance will usually cover those.
I've been told an operation can be dangerous so best to wait. I have waited and now i am close to an operation and older than when it was first diagnosed. I would have preferred an operation earlier but i am not the surgeon. I hope they know what they are doing. They tell you to avoid stress, in this world? Good luck with that, and also not to lift over 50 pounds. That gives me a good excuse at the gym
What about the Endovascular (TEVAR) procedure? I've been reading about this procedure and it seems to be much less invasive. Like so many people in this forum, my aneurism diagnosis (even though it's under 5 cm) has really changed how I live my life and if this was a treatment option now, I'd probably do it.