Aortic Aneurysm

[Stacy Frank]

My husband is 32 and had open heart surgery in March 2007.  He had a congenital heart disease (aortic aneurysm), that was able to be corrected.  It is similar to Marfan's Syndrome, but he did not meet all of the criteria.  The surgeon replaced the aneurysm with a tube graft.  Also, he has a bicuspid valve instead of a tricuspid valve, which upon surgery they found was still very functional, so no surgery was required there.  Also, the surgeons performed a maize procedure due to slight afib he was experiencing prior.  He has recovered from surgery quite well and has been taken off all meds (except Aspirin), which I find amazing.  No beta-blockers etc.  He is quite well.  The surgeon said he is an otherwise healthy male.  Clean arteries, low cholesterol, good blood pressure, healthy body weight.  He just had this unfortunate genetic glitch.  

My question:
What are his limitations in life?  We are finding so many activities we want to enjoy since in our view he was given a second chance.  Can he parasail?  Can he get into Hot Springs waters (Colorado), can he ride in a hot air balloon?  The cardiologist is so vague.  Please help us!  He says he feels great, but we just don't want to push the limits if it is not in his best interest. What should he not do, as far as physical limits go.  What can he do?  

Thanks,
Stacy and Frank
Indianapolis, Indiana    

[Nucleic60]

S+F,
Aneurysm repaired at age 42, I'm now 46.  BAV repaired, but native valve maintained.  Same genetic issues as Frank.  I will tell you what my surgeon told me; live life.  I may be back in 7 years 10 years,  decades, or never to repair my valve.  But no coumadin until if and when that ever has to happen.   I snow ski, downhill mountain bike, excercise (weights <1/2 my body weight), bike, etc.  I think I live a pretty full life.   High blood pressure needs to be carfully watched.  Don't worry, just be cautious.  

[Avel]

Hi Stacy,

Bicuspid Aortic Valve Disease is a congenital, genetic condition. It may have characteristics that seem similar to other syndromes/connective tissue conditions, but it is a "syndrome" in its own right. Since it may affect multiple family members, accurate diagnostic screening of your husband's blood relatives is important - there is a lot of variation in when/how it may affect members of a family.

I am so glad that your husband's aneurysm was found and has been removed. Lifelong follow up is important. For additional information, I encourage you to visit the Bicuspid Aortic Foundation's website at www.bicuspidfoundation.com

Best wishes to you and your husband,
Avel

[Cleveland Clinic]

I am concerned that the bicuspid valve was left in place, because these degenerate at a faster rate than native tricuspid valves, and so he will probably need a second reoperation sometime in his 40s to 50s to replace the valve. I am assuming that there is no residual distal aneuryms, because if so he may also need to be operated ( surgery called an elephant trunk) where a second distal graft is placed to protect the descending aorta.
He may engage in an active lifestyle provided that his blood pressure and especially his pulse are  well controlled. THere is some anectdotal evidence that statins decrease the progression of aortic sclerosis but this is not well estavlished. So he may be placed on a cholesterol lowering drug, especially if his is elevated.
We suggest that you don't participate in either contact sports of endurance sports ( marathons, triathlons, etc) for obvious reasons. But he may engage in casual sports and other activities that don't place so much stress on the vascular system. He should limit himself by any symptoms of chest pain or shortness of breat, palpitations, headches ( as these may represent hypertension).