Thoracic Aortic Aneurysm Repair

I'm a 33 year old male from NJ, 5' 10 approximately 185 - 190 lbs. with 15% body fat.  I was diagnosed with mild sleep apnea (14 episodes per hour) 2 years ago and have been using a CPAP machine each night.  I run approximately 3.5 miles 4 - 6 times  per week.  I also lift moderate to heavy weights approximately 4 times per week.  I was diagnosed yesterday with a ascending thoracic aneurysm which measured 4.2 on an echocardiogram and 4.5 on a CT scan with contrast.  My doctor just put me on 5 mg of Bystolic (nebivolol) which is a beta-blocker that just came on the market this year. (The insurance company has yet to approve it.

I made appointments to see 4 different Thoracic surgeons - 2 in NJ and 2 in NY.  I think it's in my best interest to have the surgery to repair the aneurysm now while I'm young and fit.  Does anyone agree?

After searching the Internet for the last 3 days, I'm pretty apprehensive but I don't see any other solution other than surgery.  I can't sit around and wait for this thing to grow and potentially burst.  

Is anyone out there that had the surgery in their 30's?  What can I expect?  How long does it take the average person to recover?

I can't imagine not have an extremely active life style.  I want to lift weights and keep running but I not sure any doctor will allow?  

[upchurch131]

I am in my early 50's and have been watching this thing grow for 10 years.  I am now 5.3cm and looks like surgery bait for this and an aortic valve replacement (bicuspid).  I would think you have some room to play right now.  I was static for the time this condition was discovered until last April when it started enlarging again.  Everyone is different and you may find that you can wait if you choose.  I'm told the "magic" number is 5.0cm.

upchurch131

[Lee Kirksey, MD]

The natural history of growth for thoracic aneurysms is poorly documented in the medical literature. For infrarenal (below the kidneys) we generally use 5-5.5cm as a cutoff for repair in a health person. This varies in the thoracic region based upon the particular location

[pusher]

I too have a thoracic Aortic Aneurysm along with several Abdominal Aortic Aneurysms.  The very first thing my cardio doc and my vascular doc said was NO WEIGHT lifting.  If you have not been told that I would think you should ask them about it.  I have a pretty bad heart to boot and was told that they would want to fix the Thoracic aneurysm as soon as it reached 5.0 cm.  I am at 4.5 cm and have been there for several years now with only very minor change in size per CT scan.  It could be several or many years before it gets big enough to repair.  

You could be fine for a long time before you would have to have a repair.  They generally don't repair these until the risk of rupture is greater than the risk of surgery along with the overall health of the patient and the exact location of the aneurysm itself.  You could be an old man before all the parameters are met.

Good luck to you and ask about the weight lifting.

Pusher

[zp1974]

Thanks everyone for your responses.  I've seen 2 docs so far.  One told me to do nothing but walk.  The other (a very good cardio / thoracic surgeon) told me I could run (slowly), golf, play tennis, swim, and even lift light weights.  When I asked him why there was such a difference in opinions, he said exercise and quality of life was important.  I'm going to see a cardiologist today and a third surgeon tomorrow.

How did those of you with a similar diagnosis handle the mental aspect?  I feel as though I'm waiting around for this thing to dissect or rupture.  After all the exercise and healthy eating I've done over the past 20 years, this is the last thing I would have expected.  I need to shake the depressive mood I'm feeling but it's hard.    

[upchurch131]

The mental side of this for me is tough. I've had previous experience with another type of surgery that didn't go well as well as other life lows that do not play well into my current situation. The love and support of those closest to you are extremely important as well as faith. We don't want to feel diminished in any way and the loss of "control" is at times overwhelming. It is difficult to wash these things from your mind- the "what-if's". You can't help but think about being a mere mortal. I had a previous bout with depression and I have been put back on medication to help with the anxiety and depressive moods. It seems to be helping a little- which is a relief.

[pusher]

Learning to live with a potentially dangerous health issue isn't easy.  Upchurch131 mentioned the support of family and friends is important and that is so true.  But, you are the one dealing with it everyday and I know how hard that is.  You can't always burden those closest to you with your health problem either, so you end up dealing with it yourself most of the time.  The biggest thing is it gets easier as time goes by.  You haven't had alot of time to get used to this yet so be patient.  Medication helps many people and you may decide that it would help you.  Talk to your doctor about it.

Good luck

Pusher

[Jo205]

I had surgery for exactly the same thing (aorta measured 6cm) when I was 34 (am now 40). They think the inflammation might have been caused by giant cell arteritis that has now 'burned out'. Had surgery in the UK - dacron graft onto aortic arch and valve repair - and took about 12 weeks in total to be fully fit. As I'm on betablockers I'm still finding exercising aerobically a bit hard and haven't yet had consistent advice.  Mentally, both before and after the surgery I tried to use the Dalai Lama's motto about worrying - if it is in your control to do something about a problem then do it, but if it's beyond your control then there really is nothing to be gained from worrying. May sound trite but it did help me. My cardiologist believed surgery would be necessary at 6cm (my aneurysm was only noticed - fortunately for me -  at 6cm so no there was no pattern of growth as in your case). Perhaps it may help you to make a decision about surgery yourself at a certain cut-off point (if you can, not sure about the system in US - would be doctor's decision here in UK!) Most advice seems to suggest lifting weights would not be good, but other forms of exercise OK. Good luck whatever you decide.