Should I do heart surgery now?

Question

I did my echo and the results show my aortic root to be enlarged. The echo reads, " There is severe dilatation of the aortic root. A CT was ordered also and the findings are: Stable aneurysmal dilatation of the aortic root measuring 4.3 cm (re-measured) and aneurysmal dilatation of the ascending thoracic aorta at the level of the main pulmonary artery measuring 4.3 cm (re-measured). The aortic arch again measure 3.4cm. The descending thoracic aorta at the level of the main pulmonary artery again measures 3.2cm and the descending thoracic aorta at the level of the diaphragmatic hiatus again measures 2.8 cm. The heart is mildly enlarged. The pulmonary artery is not dilated. 
Can anyone tell me if surgery is a must at this point I will be seeing my doctor again this month to discuss this.

skydnsr · Accepted Answer

Did not see the 5.1, so yes, that does make a difference.  5.0 is the usual criterion, and more so if there is fast growth, so what the doctor is telling you is standard advice.  Good luck on your surgery.  Outcomes are very good with a skilled surgeon and a skilled team.

skydnsr · Answer

Please do.  We will be thinking about you.

migabeck · Answer

Thanks again will keep you posted.

migabeck · Answer

Thanks Skydnsr, My Doctor specializes in this kind of surgery and when he look at the Echo from 18 months ago the size move from 3.8 to 5.1 and he is not comfortable with that so he want to repair it now in Dec.

migabeck · Answer

Thanks Jerry, my problem is my Aorta is enlarged and have to be fixed. Right now it measure 5.1 cm and that is not acceptable in the medical field that is very risky and it keep growing. I agree with doing the surgery now and don't wait until it get out of hand. Thanks again.

skydnsr · Answer

I doubt the doctor is going to tell you at this next appointment that it's "go time," but if I were you, I would definitely be researching who I want to do the surgery when the time comes. I looked at your profile, and you live in the NYC area, so you have the luxury of being able to choose a surgeon who specializes in thoracic aortic aneurysm repairs. Having a surgeon who is highly experienced in this particular procedure is crucial. You want someone who is known among his peers for his skill in repairing thoracic aneurysms. IMO, it's not too early for you to personally consult a surgeon and get his estimate of how long it might be until you need the surgery, as well as his recommendations for presurgical monitoring. If you need more help in figuring out how to find an expert surgeon, post back, and I have some ideas. Good luck.

Jerry_NJ · Answer

Your question is very technical, and I see you have a followup with your doctor, that's where you answer lies. 

For my experience, we put off open heart surgery to repair my leaky mitral valve until it had caused troublesome enlargement of the left atrium.  I was receiving treatment for atrial fibrillation during this period.  My doctor never mentioned the word surgery until one day he said my left atrium was getting to large and he would no longer try to convert my AFib, I had to consult a surgeon.  Within a year I had open heart surgery to repair my mitral valve.  That was a success and has held up fo 6 years so far, but the enlarged left atrium has left me in permanent AFib. Would have surgery earlier prevented the enlargement and thus let me live with normal sinus rhythm?  Who knows, but its to late for me to do anything.

My take away is sooner is better than later, but risk has to be taken into consideration.  I think open heart surgery by a surgeon with a good track record is an acceptable risk, I had no complication from the surgery, I have complication from left atrium enlargement.