Ascending Aortic Aneursym

[slr1]

I'll try to make this as brief as possible:

.MI at 32; closure of right coronary artery.  Undiagnosed for four years.
.MI at 36. Two separate angioplasties. Emergency quadruple bypass surgery.
.Secord quadruple corornary bypass surgery five months later.
.At 52, angioplasty attempted on fem, emergency fem-fem bypass followed.  
.Aortofemoral bypass surgery eight months later. Complications -tricuspid valve regurgitation, mild pulmonary hypertension, enlarged liver - extreme fatique, shortness of breath.  Gastrointestinal doc said right-sided failure, cardiologist said "de-conditioning."  Cozaar, lasix, potassium helped, although it took several months. Follow-up showed ascending aortic aneurysm, which has been closely monitored.

Currently 54 y/o (female) taking Toprol XL 50 mg, Zocor 20 mg, Zetia 20 mg, Plavix 75 mg, and aspirin 325 mg. Blood pressure 120-140/70-80, although surgeon would like it down to 110/70. Could lose probably 5-10 pounds.  EF is about 55. Until difficulty with legs, worked out religiously - couple hours/day, five days/week, aerobics and weights.  Since that time, really have done little because of fatigue.  

This week saw surgeon after aortic scan - aneurysm grown (3.6 or 3.8)- looking at surgery in next three to four years when it reaches 5.5. Live in small town WI and think second option from doc at Cleveland Clinic in order - or is it too soon?  Would also like to know risks of surgery, alternatives, current research, and symptoms to watch for.

Much more to ask, but reached 1600 maximum! Thanks so much!

[Cleveland Clinic]

slr,

thanks for the post. You certainly have coronary disease in your genes. Im sorry to hear of all your troubles.

Anuerysms can be stable for years in size. The rate of growth or size of an anuerysm are general guidelines for repair.

Expansion with a growth rate of 1 cm/y or faster is an indication for elective surgical repair.

For you, a 3rd redo operation is no small feat. If you are experiening rapid growth over a year or approaching the absolute cutoff, there would be nothing wrong with seeking an opinion here.

Dr Marc Penn is a cardiologist who specializes in aortic disease and works closely with the surgeons. If you wanted an opinion, he would be my choice.

good luck

[Kristin391]

Hi,

I can understand your symptoms with right heart failure.  I have had two open heart surgeries and did have pulmonary hypertension and right heart failure before and after the second surgery.  Anyway, I am from WI  and did consider going to Cleveland Clinics or Mayo Clinic but insurance didn't permit that. So, for the second surgery I went to the best that Milwaukee St. Luke's has to offer...Dr. Paul Werner.  He does aortic aneurysm repairs and has done many of these.  I did extremely well and would recommend him to anyone.  There was no comparison between him and my first surgeon.  So, if you can't go to Cleveland because of insurance this may be another option.