Heart aneurysm

Very helpful comments. I am in the same boat as azitavahid, 62 with 4.9cm. Very stable and slow growth over last 25 years. My surgeon wants to wait until 5.5 (I’m not tall) but says he will do it now if I want. Says I could get another on either side of the repair (I don’t understand that) which sounds very pessimistic based on my good overall health and very stable aneurysm over last 25 years. So, I’m feeling very anxious with my current condition and left feeling concerned about post surgery. Anyone ever been told anything like this? I was hoping to endure the surgery and finally have some peace…

1. SURGERY: I dissected suddenly at 50 in 2015. I would definitely NOT recommend it. If your doc says have the surgery, have the surgery. You will likely not survive a sudden aortic dissection, especially if you are not within 15 minutes of a world class cardiac surgical center. A planned surgery allows your doctor to be fresh, ready with all that's necessary in terms of blood products, grafts, etc. The nursing team is prepared. A sudden dissection is emergency surgery and the survival rates plummet compared to planned surgical interventions. You are going to want to have your affairs in order and allow your family time to plan for your recovery. I would not wait a second if my docs told me to have surgery.

2. RECOVERY: It took 2 years for me to feel pretty okay. 5 years to be better than my old self. That was my experience. My dissection was sudden Type A-1 aortic arch dissection that spiraled down the length of my aorta to my femoral arteries. Think of it like a stocking with a tear that starts at the top and works its way downward. Not good. I had no idea I had a problem. I was in a coma for a couple of weeks following surgery and endured complete Deep Hypothermic Complete Circulatory Arrest. A sudden complete sudden dissection is a personal, medical, professional disaster. Again, a planned surgery is going to almost always have a better outcome.

3. TRAVEL: I just got back from a 3-hour flight this weekend. I am 60. I would not take a 16 hour flight with this condition unaddressed. I say this for several reasons:
A) the stress of travel helped trigger my dissection (I was on a long business trip when it happened);
B) If you dissect in the air you are not going to survive. It's just way too complicated and lethal a medical event to ever be properly handled at 37,000 feet or over the ocean.
C) My hospital bill was $1.4 Million Dollars but was covered completely by my health insurance because of Obamacare. Do you have health insurance that will cover your medical care halfway across the world? Your insurance will not cover you for international travel, ever. You have to purchase a separate policy for that.
D) Your care team cannot come to you in whatever place you're going 16-hours away and there's a lot of places in this world that do not have the kind of medial expertise that exists here in the States.
E) Your family is going to have to come to your rescue if you dissect in a faraway locale. It was a personal nightmare and traumatizing for my wife to have to drop everything and leave our 3-year old, 6-six year old, and 9-year olds, behind to come rescue me and bring me home after 3 weeks in a cardiac ICU in California. I cannot imagine doing that to anyone again.
F) If you survive, and you're 9,000 miles from home in a foreign country, do you have medical insurance that will medevac you back to the states if necessary? If not, those flights start at $300,000 and go up from there. I have represented a client who was charged $145,000 for a medical flight from Bismarck, ND to Minneapolis, MN. Factor that in before you travel internationally.

So, I think the responsible thing to do is to listen to your care team and decide when the best time is to have the elective surgery now so that you can make a plan for what's ahead of you. My life is AWESOME now and I am thankful every day for having survived, but I would have dealt with it a lot differently had I known what awaited me. Peace.

1. SURGERY: I dissected suddenly at 50 in 2015. I would definitely NOT recommend it. If your doc says have the surgery, have the surgery. You will likely not survive a sudden aortic dissection, especially if you are not within 15 minutes of a world class cardiac surgical center. A planned surgery allows your doctor to be fresh, ready with all that's necessary in terms of blood products, grafts, etc. The nursing team is prepared. A sudden dissection is emergency surgery and the survival rates plummet compared to planned surgical interventions. You are going to want to have your affairs in order and allow your family time to plan for your recovery. I would not wait a second if my docs told me to have surgery.

2. RECOVERY: It took 2 years for me to feel pretty okay. 5 years to be better than my old self. That was my experience. My dissection was sudden Type A-1 aortic arch dissection that spiraled down the length of my aorta to my femoral arteries. Think of it like a stocking with a tear that starts at the top and works its way downward. Not good. I had no idea I had a problem. I was in a coma for a couple of weeks following surgery and endured complete Deep Hypothermic Complete Circulatory Arrest. A sudden complete sudden dissection is a personal, medical, professional disaster. Again, a planned surgery is going to almost always have a better outcome.

3. TRAVEL: I just got back from a 3-hour flight this weekend. I am 60. I would not take a 16 hour flight with this condition unaddressed. I say this for several reasons:
A) the stress of travel helped trigger my dissection (I was on a long business trip when it happened);
B) If you dissect in the air you are not going to survive. It's just way too complicated and lethal a medical event to ever be properly handled at 37,000 feet or over the ocean.
C) My hospital bill was $1.4 Million Dollars but was covered completely by my health insurance because of Obamacare. Do you have health insurance that will cover your medical care halfway across the world? Your insurance will not cover you for international travel, ever. You have to purchase a separate policy for that.
D) Your care team cannot come to you in whatever place you're going 16-hours away and there's a lot of places in this world that do not have the kind of medial expertise that exists here in the States.
E) Your family is going to have to come to your rescue if you dissect in a faraway locale. It was a personal nightmare and traumatizing for my wife to have to drop everything and leave our 3-year old, 6-six year old, and 9-year olds, behind to come rescue me and bring me home after 3 weeks in a cardiac ICU in California. I cannot imagine doing that to anyone again.
F) If you survive, and you're 9,000 miles from home in a foreign country, do you have medical insurance that will medevac you back to the states if necessary? If not, those flights start at $300,000 and go up from there. I have represented a client who was charged $145,000 for a medical flight from Bismarck, ND to Minneapolis, MN. Factor that in before you travel internationally.

So, I think the responsible thing to do is to listen to your care team and decide when the best time is to have the elective surgery now so that you can make a plan for what's ahead of you. My life is AWESOME now and I am thankful every day for having survived, but I would have dealt with it a lot differently had I known what awaited me. Peace.

1. Mine dissected at 6.5cm. The greatest pain I have ever had to endure.
2. Mine the same - dissection to the L/R Iliac.
I am getting to 1 year since surgery. I would not recommend surgery at a later stage of aneurysm. Mine was immediate and emergent. No planning, no preparation. I didn't know what they were going to do. I was only asked what kind of valve.
3.
A) Personal stress was a factor.
B) I would agree. I called an ambulance that did not arrive. After we waited 30 minutes, my wife drove me to the hospital 11 minutes away - thus saving my life. I was immediately triaged and portably scanned and within 30 minutes they new what they were dealing with, but there was more to follow.
C) Not an issue for me at the time. But I have traveled before and I cannot do it now for fear of something happening on the journey. I have been to a hospital in a foreign country and I would not survive now, let alone if I had that same experience again.
D) I concur. My own country has good medical care, but if I had to go through that layer of difficulty to be treated then that would only add to the time to be treated, And recovery, let's not forget trying to recover away from home.
E) I only survived through a network of support from family. Check B) above.
F) If I had to check insurance to see if a situation is covered and by how much then to me that is a red flag in the first place.
I agree with moonboy's final comments here. I never knew I had anything until the night it happened. I did travel on a four hour road trip the weekend before and another a weekend before that. Our extended family has discussed how we would have dealt with that situation if it had happened when we were away.
We wouldn't have.
Right now I am mentally juggling how I am going to have INR tests if I do travel. And how I would take medication. If I had known of my condition I would not have done any travel.

I am so glad you recovered from this horrific ordeal. You are the second post that I’ve read that mentioned they would never travel. My aneurysm was just diagnosed at 4.1 for ascending aorta. Would you have felt comfortable traveling within the United States within aorta aneurysm of that size? My cardiologist said air travel was fine, but I’m reading more and more people that say they feel travel contributed to a dissection?

Mine is 4.3 and I’ve traveled abroad a few times this year. I’m 57, normal blood pressure, active, good health. This group is amazing but unfortunately, all doctors seem to give different opinions on restrictions. My thoracic surgeon (went for consult) said ascending aortic aneurysms are not caused from high cholesterol. He did not seemed alarmed and had a relaxed bedside manner. Wait and watch, no restrictions other than lifting anything over half my body weight, watch my bp (which is normal). My concierge doc who is internal medicine told me to “find something else to worry about” after viewing my contrast CT showing 4.3 aneurysm.
Mine was initially found during an elective CT calcium heart scoring test. My calcium score was zero, the aneurysm appeared to be “up to 4.5”. Echo was done and it was 3.6, and contrast CT showed 4.3. I’ve decided to just live my life and keep and eye on it. Living in fear won’t make it smaller but it could make it worse..