Should I get a second opinion about surgery?
Hi all, my name is Pattie. I was diagnosed Oct 2024 with giant cell arteritis which led to a CT scan. It was discovered that I have an ascending aortic aneurysm, 4.8cm to 5.3cm (depending on who's measuring). I just finished prednisone treatment for the GCA, supposedly it's in remission now. I was referred to cardiovascular thoracic surgeon for the aneurysm. She recommended open heart surgery to repair it with a graft. My valve is normal tricuspid. She's "calling" the aneurysm size 5.0, as she is "taking an average" between the measurements of 4.8-5.3 (obtained by 2 radiologists and an interventional cardiologist). Not clear if she actually measured it on imaging herself. She said my surgery should be "sooner rather than later" but that it's not "emergent", although she doesn't recommend a period of "watchful waiting". She's been pretty vague on the timing. Her rationale for surgery: She says 5.0 meets threshold for surgery, and that the "integrity of my vascular tissue may be compromised" due to GCA, and also family history... my father died at 63 from sudden cardiac death (unknown if caused by aneurysm, although he had hypertension and atherosclerosis). I also have hypertension (now controlled with BP meds).
I am 75 years old, 5'9" tall, very slim. I've read about aneurysm size (and also a person's height/body surface area) and such conflicting information about when it's appropriate to intervene surgically, including reports from people in this forum who have lived with their aneurysms that have been stable at larger sizes for years etc.
Getting very anxious about who to believe/trust. I am terrified at the thought of open heart surgery and the extensive recovery period. The hospital here is nice, the surgeon seems nice, but she said the hospital only does 10-12 aorta surgeries a year. I've done extensive research and reading. Wondering if I should seek out a second opinion from a reputable, high volume heart center. I'm in California... Stanford, UCSF, Cedars Sinai in LA all have second opinion services available online (you get a written report), but it's expensive of course. I suspect I'm probably going to get the same recommendation from other professionals, telling me to proceed with surgery. Does anyone want to weigh in on whether they think it's worth the hassle and expense for me to get a second opinion?
I'm just a bundle of nerves and so undecided about everything. Thanks in advance for any advice that's offered!
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Wow! The attention you received at Mayo PHX has been speedy and thorough! Impressive. You’ve received care from top notch places. That’s wonderful! And so encouraging to know that your experience with Stanford was excellent. Thanks for sharing that! Wishing you a very successful surgery on July 8th. Sending healing thoughts and positive vibes. You are very brave!!
Oh my goodness… I am SO sorry to hear that you experienced dissection. I can’t imagine. So incredibly scary. But you made it through, which is amazing. What a miracle.
Thanks for your encouragement for getting a second opinion and proceeding with surgery if recommended (I strongly suspect the surgeon will say I should do it)… although I can always hope for “watchful waiting”… but then, that scenario has its own set of anxieties!
Yes, I do think this will probably not be a watch and wait situation… thank you for weighing in! So encouraging to know your surgery was successful and that you are back to an active lifestyle! I like to walk and hike, so continuing that is a huge goal for me. Good to know that walking daily is recommended post surgery!
My biggest worry is my age (almost 76) and how that will impact my surgery outcome and recovery. Well, I have a million questions and hopefully I will get most of them answered at my 2nd opinion appointment next week! Thanks so much for your good wishes!
I have had gated cts and they are covered by Medicare. I have to pay a $200.00 co-pay whether it’s gated or not.. I would not feel comfortable not knowing the size of my aneurysm, mine is 4.9!
I bet you can find one!! Good luck!