aortic root

[Billy5]

Enlarged vs dilated aortic root. These two descriptive terms commonly appear on cardiac reports, and are often used interchangeably.Does anyone have an opinion on appropriate and correct use of each of these? Would you,please explain (be specific) what does it mean when on average middle age male patient cardiac mri report is written the following "There is mild prominence of aortic root which measures 3.9 cm at sinuses of Valsalva.The sinotobular junction is maintained.More distally,the thoracic aorta is normal in size.There is no evidence of dissection." What's the ideal blood pressure for prevention of aortic root enlargement/dilatation? Thank you

[CCF-M.D.-MJM]

Hi Billy,

There is not strict definition of enlarged versus dilated -- subjectly, I would say that I would use the word dilated for aortic roots that are larger than "enlarged" aortic roots, but the key factor is the measurement, not the wording.  Either words, I cannot be specific about the difference between these words because there is not strict definition.

I would interpret this to mean that your aortic root is slightly larger than normal at the level of the sinus of valsalva, but nothing that I would take action on based on this report.  It should be followed over time with routing MRI's or CT's to evaluate for enlargement and the rate of enlargement.

What's the ideal blood pressure for prevention of aortic root enlargement/dilatation?

Blood pressure is important, but so is the hearts force of contraction.  First, you should be on a beta blocker to decrease the force or pressure change per unit time (the so called dp/dt).  Second, the best blood pressure is the lowest blood pressure you can tolerate without symptoms.  Unfortunately, neither of these measures guarantee that you will not progress.  That is why your aortic should be imaged routinely.

I hope this helps.

[pbanders]

The onset use of terms varies somewhat, and has changed over the years. It's related to the number of standard deviations away from the population mean, the doctor here should know the latest numbers. Note that what is "normal" also varies by body surface area (BSA), a person with a larger BSA will normally have a larger aorta.

What's more of concern is if the aortic root is large enough such that aortic dissection begins to become likely. This begins to become of concern when it exceeds about 5.0 cm. The other concern is the rate of progression. For example, an aortic root that is stable for years at 4.0 cm is less of a concern than one that in a two-year period progresses from 3.5 to 4.0 to 4.5 cm.

Were these data from echo readings, or from CT or MRA?

[desertrat49]

Have you just been diagnosed as well with a mildly dialated   aortic root?  I was approximately a few weeks ago upon going in for some pre-op tests prior to knee surgery.  Something, looked suspicious on one of my lungs, so, a CT scan was ordered. Lung spot was nothing but scar tissue, but, the scan showed this dilation.  I am in SHOCK and very very frightened.  I have been on the internet daily.  They also did a echo on me.  The Ct scan measured the dilation at 4.2 and the echo came back with 4.0..Either way, I don't like what I heard and what I have read about this.  There are some well-versed people on here that in no time will hopefully help you out.  I knew nothing about this until I was diagnosed.  I am a 55 year old female.  Please stay in touch.  This will be our comradarie in our quest to talk to others who have been in our same boat and those that are where we are now.  I am still trying to get rid of the knot in my stomach.  I cannot spare to lose any more weight.  ANYWAY, before I go on, I just wanted to let you know there are others out here going through the same thing you are.  Christine in Florida.....Stay with this site.  It is good and there are others as well.  There are some really nice people on here.  I call them my ROCKS.....

[Jjc2005]

Billy5
My aortic root was measured at 4.0 by the radiologists but my surgeon called it 4.5
Different folks look at  and/or measure it differently is what I understood.  So you might want another reading.
I was told that at greater than 4.0, it is called an aneurysm.
I am 59 year female, 8 weeks out of surgery where they replaced part of my aorta from the root up the ascending about 3 inches with a Dacron graft.  Two weeks after surgery I was back to walking, able to do about two miles.  Now I am back to four miles and some jogging. I feel great and I really have no regrets about doing the surgery.
Because of our family history (my sister dissected and died at 4.5 cm, as well a cousin but I don't know the size), my surgeon suggested I have surgery  asap, even though rule of thumb is 5cm before surgery.  I did and I am glad I did.   For me it was the right choice.
Talk to doctors who have expertise in this area.  It is a fixable problem in many cases. As well, in many cases, all you have to do is get it checked once or twice a year.   Take care.

[Jjc2005]

Forgot to add: from everything I have read on several different sites, and from talking to my own doctors, I think that for me, my ideal bp is  110/70.   I lived with the knowledge that I had this aortic root dilation for two years before getting with the surgeon who "fixed" me.    I walked daily, kept my b/p averaging about 105/65.
Also did not smoke and ate a healthier diet and tried to get my weight down about 10 lbs.  In the two years my dilation did not change.  However from what I was told, there are no set answers as to whose dilations grown or why.  It is a gray area or so I was told. Since surgery I have been told I will remain on a low dose beta blocker and I will continue to moniter my bp and be scanned yearly.  Hope this helps.

[Billy5]

2.00--2.08 is the BSA. As for whether it is from mra,I do not know,but I do know it is from cardiac mri.What's aortic root insignificant progression rate change in 2.5 years,other than 0?

[Sueha]

I think what everyone is trying to say is that with regular monitoring, if the enlargement suddenly starts to increase than this is a higher risk than if there is little or no change in measurement. With regular monitoring if it should get to a size that is of concern then action will be taken.

My dad's AAA was 7.8 cm when it was picked up so he was in fairly quickly for a stent, he was told he could have had it for 10+ years without knowing.

[pbanders]

Just as a point of clarification from Sueha's comment - while an AAA (abdominal aortic aneurysm) can be repaired endovascularly using "stent" of sorts (but a lot more complex in structure), an aneurysm of the ascending aorta must be repaired in an open heart procedure using a tubular Dacron graft.

[Billy5]

The first radiologist report of thoracic aorta including aortic root was everything is great and normal with "IMPRESSION:NORMAL AORTA WITHOUT EVIDENCE FOR ANEURYSM OR DISSECTION." But than I guess I was not satisfied with the above radiologist normal results(because there were no measurements of aorta written on report) I requested aortic measurements (of the same study with the same radiologist) and that's how I got this aortic root measuring 3.9 cm and "I do not see evidence for aneurysmal dilatation of the aorta" written on ADDENDUM report from the same radiologist. 1. Do I have to or should I take blood pressure(beta blockers) drugs if my resting at home blood pressure without drugs is around 100-110/70-75? 2.Is aortic root measuring 3.9 cm on mri normal and within normal limits for my age and BSA,because evidently according to radioogist who read it it was normal? 3. Does anyone know what are adults (cardiac mri) aortic root upper normal limits?Thank you

[Gaspipe]

I would think one factor in your situation would be a family history of this problem or sudden cardiac death related to this diagnosis in your family history. good luck gaspipe

[Billy5]

As for family history both of my parents aortic root diameter is within normal range (2.0 to 3.7 cm by echo) Do I have to keep my heart rate from exceeding 100 beats per minute during (50 minutes x 5 days a week) exercise instead usual 120-130 beats per minutes?Thank you

[Billy5]

As for family history both of my parents aortic root diameter is within normal range (2.0 to 3.7 cm by echo) Do I have to keep my heart rate from exceeding 100 beats per minute during (50 minutes x 5 days a week) exercise instead usual 120-130 beats per minutes?Thank you

[zk]

There is no perfect aortic root size,but I would say if your aortic root does not change (>0.1cm) in the next 2 years and assuming your ascending aorta is 3.5-3.7 cm and descending aorta is 2.5-2.7 cm than I would say you have perfectly (the best) normal aortic root size as well as aorta.As song goes don't worry be happy.Do you agree folks?

[zk]

There is no perfect aortic root size,but I would say if a person has aortic root measuring 3.9 cm that does not change/increase (>0.1 cm) in size for two years with ascending aorta measuring 3.5-3.7 cm and descending aorta measuring 2.5-2.7 cm than I think aortic root measuring 3.9 cm as well as aorta would be normal for that person.

[Billy5]

1. Did being active (aerobic exercise,bike riding) cause your ascending aorta dilatation? If no what caused it? 2. Are aortic root(at sinus) and ascending aorta normal ranges the same by ECHO,CT,CARDIAC MRI? 3. Why are you taking blood pressure (beta blockers) drugs if your blood pressure is normal and what should your blood pressure be at rest and during exercise w/o and w/drugs to be considered normal?

[long]

What causes persons with stable aortic root diameters, 3.5-4.1cm, to stay the same (no significant interval change) while others progress to the level of surgery?

[eomai]

A related discussion, Dilation of Aortic Root 4.1 cm was started.

[Adam3]

A related discussion, Aortic Root Enlargement was started.

[milo_1]

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