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Enlarger Aortic Root

when I was 15 I had been diagnosed with and enlarger aortic root with a diameter of 4 centimeters. the other day for my one year check when I am 16 my root had enlarged .2 centimeters and now is at 4.2 centimeters. I was wondering what is there that could be done. What are some treatments?...what can I do and what cant I do?....and am I going to need surgery?.. .
33 Responses
367994 tn?1304957193
When the aortic root increases to a size greater than 4.0 cm it is referred to as an aneurysm and growth is closely monitored and grows about 0.2 cm a year.  If and when the size reaches 5.0cm, surgical intervention begins to be an option to prevent rupture.  

Do you have a bicuspid syndrome?  That would be the aorta valve with two leaflets instead of three, and the syndrome includes a tissue vulnerability of the aorta vessel wall that is usually subjected to medical problems in the 3 decade of life (sometimes for the valve as well as the vessel).

It is necessary to avoid high blood pressure, and avoid any heavy lifting. There isn't any medical therapy available.  Thanks for sharing and take care.
  
Avatar universal
does the aortic root always grow at a rate of .2 cm a year?... will the aortic root ever stop growing?.. and how is the surgery done?... thank you for giving me some answers..
Avatar universal
kenkeith is absolutely wrong that there isn't any medical therapy available.  There is.  I've posted about it here repeatedly.  You need to investigate angiotensin receptor blocker (ARB) therapy.  ARBs are a class of drugs that have been clinically proven to halt and even reverse aortic root dilatation in humans.  They include valsartan, telmisartan, and other drugs that end in -sartan.  The key is to take a high enough dosage - for most people, this is about the maximum FDA-approved dose.  In particularly large people, the required dose may be higher.

You should quickly find a cardiologist who is knowledgeable about connective tissue disease and ARB therapy.  It is cutting edge and most physicians/cardiologists are unaware of this treatment.  You might contact Dr. Hal Dietz at Johns Hopkins for a referral in your area.

Avatar universal
By the way, Pat, regardless of whether you have Marfan Syndrome or not, you might Google "losartan" and "Marfan Syndrome" to read articles on this topic.  I don't think losartan is the best ARB, but it's the one being used in the current studies.  All ARBs seem to work, some better than others. Efficacy is usually dose-dependent.


367994 tn?1304957193
QUOTE:....."necessary to avoid high blood pressure, and heavy llifting".  Beta blocker helps control high blood pressure!

Medhelp: Doctor's Answer by CCF-M.D.-MJM,
"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".<<<<<>>>>> It is important to note that treated patients continued to have abnormal aortic growth and aortic dissections, and therefore such therapy does not preclude the need for surgical correction. Significant previous aortic root dilatation correlated negatively with therapeutic response."<<<<<<
367994 tn?1304957193
**"Interestingly, selected studies suggested that ß-blockade either had no effect or worsened stiffening indexes in 35% of individuals with MFS.21 Increased body weight or an end-diastolic aortic diameter >40 mm was significantly associated with lack of desired response,17 suggesting that ß-blockers must be given at an adequate dose and early in the course of the disease to optimize the potential benefit".

**From the Department of Internal Medicine, University of Texas Medical School at Houston (D.M.M.); Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (H.C.D.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif (D.C.M.).
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