Aneurysm question

[DavesMom]

Hi,

I'm a 52 year old female with two previous open heart surgeries - the last was an aortic valve replacement/aneurysm repair in 1999. I have a bicuspid valve and am 4'11"/100 pounds.

Last year a CT scan showed an ascending aortic aneurysm of 4.5 cm. I also have aneurysms of the brachiocephalic artery (it measured 2.6 last year) and at the origin of the left common carotid artery. (1.6 cm.)

What is the significance of the aneurysms in the two arteries?  Do they normally go along with an ascending aortic aneurysm?  At what measurements do these aneurysms become worrisome?  

Thanks in advance for any information.

[Cleveland Clinic]

BAV and ascending aortic aneurysms are related due to a common problem in the proteins that make up those structures.  As a result, the other two aneurysms are also related to that as well.  Just like with the aortic aneurysm, those are also at inceased risk of rupture.  I am assuming that you are not experiencing any symptoms from either one of them.  The measurements that you mentioned above are a little worrisome to me, they are definitely larger than what the upper limits of normal measurements should be.  Again, in asymptomatic cases, the decision to operate is probably very subjective and dependent on the surgeon but in most cases rapid progressio, presence of clot or any symptoms all point toward the need for surgery.  I would recommend that you see a vascular surgeon about this sooner than later.  You should also compare the size of the aortic anuerysm from a year or two ago to make sure that the repair was good and that there is no further expansion.          

[DavesMom]

To follow up on my own post:  it probably doesn't make much difference but the second aneurysm measures 1.8, not 1.6.  

[Shelster56]

Thanks so much for your informative reply.  If you have a chance, can you please tell me if repairing the ascending aorta and arteries is a very complicated surgery?  I'm asking because my second surgery had some complications due to scar tissue, some of which caused my right ventricle to become attached to my sternum. I was wondering if I might be a candidate for any minimally invasive technique.

Thank you again.

[Cleveland Clinic]

Repair of the other arteries probably won't be that high a risk surgery.  I don't think that your aorta needs to be repaired at this point.  The fact that the RV is adjacent and adhering to the sternum is very problematic and makes redo open heart surgery risky.  I would focus on repairing the subclavian and the carotid and continue to follow the aorta.