Should 4.8cm thorasic aneurysm be reapired?

[emma60]

I have a 4.8cm aneurysm in my thorasic aorta.  I already have had quadruple bypass surgery, it collapsed  two months later and I have several stents.  I am a diabetic also.  Should I have this repaired now or wait?  I had a friend die with a ruptured aorta.  Thank you.


This discussion is related to Thoracic aortic aneurysm.

[pusher]

What does the doctor say?  Is your diabetes under control?  At what rate is the aneurysm growing?  I have one too and have been told by several surgeons that they wouldn't repair until it reached 5.0 cm and then that would depend on several other health factors.  Factors like the progression of heart disease, the condition of the Aortic Valve, Ejection Fraction in the Left Ventricle, the presence of additional anuerysms further down the aorta etc.  Those are just a few of the things they are watching on me.  
Your health condition or conditions will probably have something to do with when they want to repair your aneurysm.

[kenkeith]

The location of an aneurysm is distinctly connected with the cause, course, and treatment of a thoracic aneurysm, and the shape (fusiform or saccular) helps to identify a true aneurysm. A true aneurysm involves all three layers of the arterial blood vessel wall. For some insight the common fusiform-shaped aneurysm bulges or balloons out on all sides of the aorta. A saccular-shaped aneurysm bulges or balloons out only on one side. A pseudoaneurysm, or false aneurysm, is an enlargement of only the outer layer of the blood vessel wall. A false aneurysm may be the result of prior surgery or trauma. Sometimes, a tear may occur on the inside layer of the vessel resulting in blood entering the layers of the blood vessel wall, creating a pseudoaneurysm.

The aorta is under constant pressure from blood being ejected from the heart. With each heartbeat, the walls of the aorta expand and spring back, exerting continual pressure or stress on the already weakened aneurysm wall.  Usually exercise increases pressures and is contarindicated. Therefore, there is a potential for rupture (bursting) or dissection (separation of the layers of the thoracic aortic wall), which may cause life-threatening hemorrhage (uncontrolled bleeding) and, potentially, death.

Once formed, an aneurysm will gradually increase in size and there will be a progressive weakening of the aneurysm wall. Treatment for a thoracic aneurysm may include surgical repair or removal of the aneurysm to prevent rupture. Surgery may be indicated when the thoracic aneurysm size is greater than 5.5 to 6 centimeters (greater than two inches), and aneurysm growth rate is 0.5 centimeters (slightly less than one-fourth inch) over a period of six months to one year.

[Terri777]

Hi Emma,
You must be worried since you are a new member searching for info.
I too have an aneurysm. Mine is 4.5cm, and it's an ascending aorta aneurysm. I have CT's done twice a year.

Same feedback from my doctor as the other two reporting, wait till it's at least 5 cm.
Your body size and frame also have a lot to do with it.  A larger frame with weight can carry a bigger aneurysm.
I take beta blockers and blood pressure meds in the AM & PM.
Beta blockers to keep the beats down, less action with the thrust, and blood pressure, well you know that one.

Mine has changed just.3 cm in three years.
I exercise 4-5 times a week at a very aggressive pace in a gym for 90 - 120 minutes at a time. I lift nothing heavier than 15 lbs, and nothing over my head.
I ran a stress test earlier this year, and my cardiologist was amazed at the results.
He said to keep doing what I'm doing, avoid the cycle class, and to avoid any trauma.

My family however freaks out and would rather see me have it repaired now. My doctor and surgeon disagree. With surgery comes a lot of complications and thing to deal with later. Besides, maybe technology will work wonders for us. They all know of the John Ritter situation. I tell them, he didn't know he had an aneurysm, that's where we differ.

My aneurysm stems from a birth defect, a bi-cuspid aorta valve. Years of added turbulence caused the aneurysm.  My doctor only found all of this three years ago when he went looking to see why I had a mumur.  Thank God for a doctor who cares!!!!

Good luck, hope this added info helps.