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i was told today that my aortic root was enlarged 4.0 . what is done about this..had a double valve replacement 10 years ago and an anurysum then .i am 39 and have a pacemaker
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A 4.0 cm aortic root is enlarged but is not generally considered critical.  You have time to figure out what you want to do, who you want to do it, and where you want to have it done.  Surgical criterion is 4.5 to 5.5 cm, depending on the surgeon's judgment and the particulars of the case.  Maybe you will be lucky and it won't get much larger, and you will never have to have it operated on.  But finding out about it at this stage is an opportunity to do your research and to consider your future decisions.  Controlling blood pressure will be extremely important, as high blood pressure can make the aneurysm grow.

If the previous aneurysm involved the root, it may not have been adequately repaired when you had your first surgery.  The goal of aneurysm repair surgery is to cut out all the bad tissue, so that the aneurysm does not recur.  Aortic root surgery (and really, any aortic surgery) is very specialized and requires a high, high level of expertise, in order to do it well.  Not every locality has an expert aortic surgeon.  Aortic surgery is unusual enough that your average "heart surgeon" may not get adequate opportunity to become really proficient at it.  Also, aortic medicine is an emerging area with new knowledge coming out all the time, so 10 years ago is a long time, in that context.  

If the new aneurysm is in a completely different spot than the last one, then I would say it is pure bad luck that you got another aneurysm, and the new one probably has nothing to do with your previous surgery.  Anybody who gets one aortic aneurysm is more prone to future ones than an average person who has never had an aneurysm.  For anyone who has ever had even one aortic aneurysm, regular monitoring of the whole aorta is recommended for life.  People who have had an aortic aneurysm are also at higher risk than most people for brain aneurysms, so you might want to be screened for that, also.  The relatives of aortic aneurysm patients are also at risk for aneurysms, so they might want to have their aorta, and maybe their brains, screened at least once.  

For more information about aortic disease, including aneurysms and aortic valve defects, see www.bicuspidfoundation.com.  It would be a good idea to look for a thoracic aortic surgery center in your region.  Good luck.
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