Early surgery: Can I get aortic aneurysm repair before it's 5.0?

Posted by ontogenyx @ontogenyx, Sep 26, 2020

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?

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

@realitytest

Wow! That certainly IS young. Is a CT scan the usual way to check for aneurysms? How else do people find out?

My ex-husband died suddenly of a burst aneurysm a few months ago, and our sons were advised to be checked for aneurysms. I hope their insurance covers a. CT scan on grounds of their being hereditary high-risk.

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Insurance I think should cover. I had to have both my kids tested for bicuspid aortic valve because I have that- insurance did cover both of their 2 d echos to rule that out. I am guessing also it is dependent on what caused the aneurysms. For me it was a congenital heart defect- my aorta was kinked- CoA- because of that and not a generic link they didn’t have to get the scans for the aneurysm. But any tests that was recommended by my cardiologist the pediatrician had no problem getting them ordered and covered- I am sure it would be the same for adult children as well.

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@douglasebaker

Believe me, do not get the surgery, .you are fine. The surgery is as invasive as open heart surgery. My Aorta is 5.1 cm and my cardiologist will not be concerned until 5.5csm. However, I do have a ct scan check every year to monitor any changes, So far no changes. Furthermore, No one has any idea if this has been the size of my Aorta for years. I would take the yearly monitoring route and ease your worry.

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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.

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@jgreenwalt

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.

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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

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@realitytest

Wow! That certainly IS young. Is a CT scan the usual way to check for aneurysms? How else do people find out?

My ex-husband died suddenly of a burst aneurysm a few months ago, and our sons were advised to be checked for aneurysms. I hope their insurance covers a. CT scan on grounds of their being hereditary high-risk.

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Start with an echocardiogram first. It should identify an aneurysm if present and well as any valve issues. Insurance will usually cover those.

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@breick

Start with an echocardiogram first. It should identify an aneurysm if present and well as any valve issues. Insurance will usually cover those.

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Thank you for your reply.
I thought there were also abdominal aneurysms, in which case the aneurysms wouldn't show on echocardiograms (not true?).

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@realitytest

Thank you for your reply.
I thought there were also abdominal aneurysms, in which case the aneurysms wouldn't show on echocardiograms (not true?).

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There are abdominal aneurysms, but this thread is referring to aortic aneurysms. I believe that they both can be viewed via ultrasound.

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