my 4 year old son had surgery at birth for Transposition of Greater Arteries and Ventricular septal defect, now his aorta is enlarged to 2.8mm which I believe is significantly large. my question is at what measurements is surgical intervention necessary or indicated, in cases like this?
Patients with conotruncal abnormalities like transposition of the great artereis (TGA) with ventricular septal defect (VSD), Tetralogy of Fallot and Truncus arteriosus, all start out life with blood vessels connected to the left ventricle that are larger than normal. So after open heart surgery, they remain larger than normal. In TGA with VSD, the new "aorta" actually started out as the pulmonary artery, and we believe that some of the stretching that occurs in the neo-aorta over the years has to do with the fact that pulmonary artery tissue and native aortic tissue are not exactly the same. Thus, the neo-aorta may stretch in response to the higher blood pressure of the body (compared to the pressure in the lungs). Regardless, the decision to intervene surgically is based upon how quickly the root is changing in its size and if there is significant leakage of the neo-aortic valve. So if the size of the aorta has been relatively stable, and there is little to no valve leakage, it can just be watched. If the size is changing rapidly, then a consideration for surgery might be entertained. However, in the big picture, it is only a minority of children who come to another heart surgery for this issue, which is present in many.
Hi! I'm a parent to a TGA/VSD 3 year old boy : ) We also have aortic dilatation, as do several of the TGA kids I know. My son's ascending aorta is 2.7, his root is 2.4 and his arch is in the 1's..we have learned that the z-score is important as a measurment tool because it levels the playing field and indicates how abnormal the aorta is in comparison to height and weight. We have been told not to worry unless it grows .5 or more per year or doubles(?) it's original size. And as the doctor here said, if it starts to leak a lot. It is very rare for kids to have surgery for this, but it does happen and for some reason our kids with VSD's are more at risk for dilated aortas, if I remember correctly. I was pretty worried about it for a long time but I noticed on my sons echos he had one year that it grew, one year that was stable, one year that it grew, and one stable..I think a lot of it is his growth spurts..Anyways, just wanted to say "hi'!
Copyright 1994-2017MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.