Aortic Aneurysm, exactly what is it

[rockhaven]

My husband was recently told he has an Aortic Aneurysm.  He is 52 and has had 3 aortic valve replacements (Star Edwards, Pig and St. Jude), and we are quite concerned about this new development.  For the past 6 weeks since the diagnosis, we are still no closer to finding out what this is and what it means.  We will be seeing a third doctor next week; the first 2, although heart specialists and referred by each previous doctor, were not the correct ones to handle this, and would not give us any satisfactory information (said they were not really equipped to discuss this, and we would have to talk to the correct surgeon.)  I am quite concerned about the cavalier attitude, and the time-frame involved from the first diagnosis. My readings tell me this is quite serious and can rupture without any warning causing death - yet the specialists in the field treat this as a nothing. Can you give me some assistance...

[Avel]

I want to mention additional resources for families with aortic aneurysms. There is a book called "State of the Heart" by Larry W. Stephenson, MD, that is intended for patients. Chapter 13 very helpfully covers anuerysms. It is available through book stores, and the professional organization for thoracic surgeons has made it available on their web site at www.sts.org
There is also a very helpful support group for aneurysm patients and their families at www.westga.edu/~wmaples/aneurysm.html This site is divided into two sections, one for those with cerebral aneurysms and one for those with aortic aneurysms.
There are several risk factors for thoracic aortic aneurysms. One of them is a bicuspid aortic valve, a congenital condition where the valve has only two leaflets instead of three. This was the case with my husband. The aneurysm developed years after the aortic valve was replaced. After finding the right expertise, my husband went on to have a very successful surgery. I have documented the experience on the aneurysm support web site in the aortic aneurysm section. It is titled "Bicuspid Aortic Valve and Ascending Aortic Aneurysm" and is located at www.westga.edu/~wmaples/velebir_arlys.html I hope this may be helpful.

[CCF-M.D.-CRC]

Dear haven,
An aortic aneurysm is a dilation of the aorta somewhere between the aortic valve and the point where it branches into the legs.  When most people say aortic aneurysm (AA) they are referring to an abdominal AA.  This type of aneurysm is very common in older persons and after it reaches a certain size (about 5cm) it requires urgent surgical repair due to the risk of sudden rupture.  Until it is this size the need for surgery is not as urgent.

In your husband's case I suspect he may instead have an ascending AA, that is the area of the aorta just above the aortic valve is dilated.  Depending on the size of the aneurysm and the associated findings of aortic requrgitation will determine the need for surgery.  Sometimes these can be watched to see if there is no progression but othertimes repeat open heart surgery with replacement of the aortic valve and ascending aorta is required. The need for surgery is not as urgent in this type of aneurysm.   If he does need surgery he could choose another mechanical valve with a dacron graft or a homograft which is obtained from a cadaver.

[debra21784]

An aortic anyerusm is a thin spot in the wall of the aorta that is usually treated by a cardiac/vascular surgeon.A graft is performed to prevent the site from rupture.I am surprised that your husband was not referred to a cardiac /vascular surgeon for repair.If you live near a teaching /academic medical center that has a staff of cardiac/vascular surgeons who perform these procedures all the time I would get an immediate appointment for evaluation and consultation.You are right to be concerned.

[kmmcf]

Hi,

My husband has an aortic arch aneurysm.  Someone on one of these site referred me to a book on Cardiac Surgery In the Adult. Go to www.ctsnet.org/book and look at chapter 40.  There is a lot of information.  Best of luck to you.

mmcf