Aa
will I need aortic root surgery
Hi,I'm a 57yr old family doctor who was born with a bicuspid aortic valve which has been deteriorating over the past few years on echo but asymptomatically until the last month when I had a small inferior myocardial infarction.I've made a good recovery and am walking well with grade 2 NYHA.My cardiologist believes that now is the time to go for AVR when my LV is still ok.A recent CT shows my aortic root to be slightly dilated at 38mm.In view of the known risk of aortic dissection/aneurysm in this congenital heart condition even with AVR,do you believe I should have my aortic root done at the same time?
Don't know much about these new anticoagulants as yet.I believe that one new drug they were trying has been withdrawn.Baz
Thanks for your reply.I haven't seen the cardiac surgeon yet and will obviously take on the best advice.I must admit that my anxiety levels are rather high at the moment.I'll keep following the info on this site.Thanks again.Baz.
A heart surgeon at Mayo Clinic states the biggest problem he sees is that a patient waits too long before surgical intervention. The consensus is the operation should be done at a time appropriate to preserve left ventricle functionality...EF of 55 to 75%. A loss of LV EF cannot be regained with an operation.
Generally, an aneurysm (root greater than 40 mm or 4.0 cm) is closely watched, and if and when the size is 50 mm, surgery would be the option. The aneurysm may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some aneursym may swell to over 15 cm in diameter before rupturing.
Before a decision to operate an assessment should be made: For a perspective, a rapidly expanding aneurysm should be operated on as soon as feasible, since it has a greater chance of rupture. Slowly expanding aortic aneurysms may be followed by routine diagnostic testing (ie: CT scan or ultrasound imaging). If the aortic aneurysm grows at a rate of more than 1 cm/year, surgical treatment should be electively performed.
There may be an advantage to correct the root anamoly at the time valve operation and the benefit out weighs risk...a surgical call, general health, etc.
Generally, an aneurysm (root greater than 40 mm or 4.0 cm) is closely watched, and if and when the size is 50 mm, surgery would be the option. The aneurysm may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some aneursym may swell to over 15 cm in diameter before rupturing.
Before a decision to operate an assessment should be made: For a perspective, a rapidly expanding aneurysm should be operated on as soon as feasible, since it has a greater chance of rupture. Slowly expanding aortic aneurysms may be followed by routine diagnostic testing (ie: CT scan or ultrasound imaging). If the aortic aneurysm grows at a rate of more than 1 cm/year, surgical treatment should be electively performed.
There may be an advantage to correct the root anamoly at the time valve operation and the benefit out weighs risk...a surgical call, general health, etc.
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