Medication or surgery for dilated aortic root

[MohanKB]

I had hypertension and was under medication for that. Then I had comprehensive cardio checkup in April 1998 at the age of 47. Since then, I have been undergoing comprehensive cardio checkup regularly following my doctor’s reporting of dilated aortic root and enlarged left ventricular ED. The following is the case history of checkups.

Age Aortic root diameter Aortic / Pulmonary regurgitation Medication
47 4.2                                                          Atenolol 25 mg, Amlodipin 5 mg
48 4.6 ,, ,,
50 4.7 ,, ,,
52 4.6 Gr – I/ nil ,, ,,
53 4.5 Gr – II/ nil ,, ,,
56 Gr – II/ nil ,, ,,
59 4.9 Gr – I/ Gr- II ,, ,,
60 4.9 Gr – II/ nil Atenolol 50mg+Amlodipin 5mg; Aspirin 75; Atorvastatin 10

Also I had CT Angio done which showed Aortic root diameter of 5.4 X 4.7 cm and partially calcified plaque lesions in proximal and mid segment of LAD (about 55% area stenosis). I have consulted both doctors, Cardio-Medical and Cardio-Surgeon who said that there was no medication for dilated aortic root and no hurry in getting surgery at this size. As per their advise I am taking three medications as mentioned.
As I live alone at work without my family most of the time, I’m bit worried about it. The doctors did not prescribe ARB. Pl. provide your advise.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

In general, a dilated ascending aorta measuring 5cm diameter is indication for replacement with a fabric graft. But this again is correlated with your clinical symptoms and other co morbid conditions like diabetes and hypertension.

Hope this helped and do keep us posted.

[MohanKB]

Thanks!
I again had ecocardiography done. Its final diagnosis are: Mild concentric LVH; Grade II LV diastolic dysfunction; dilated aortic root, ascending aorta upto first batch; mild to moderate aortic regurgitation; normal LV systolic function.Dilation of sinotubular junction is causing incomplete coaptation of aortic valve producing Aortic regurgitation.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament.
With the aortic root dilatation is there any evidence of aortic regurgitation? The prognosis depends on your clinical presentation, the present diameter and the other co morbid conditions like diabetes. For LAD stenosis, if it is causing significant blockage then intervention may be planned. If your symptoms are adequately controlled with medications then you may not need any intervention now.

Hope this helped and do keep us posted.