Ascending Aortic Aneurysm with BiCuspid Valve

[AaronJ]

Hi there, I'd like to thank you in advance for taking the time to answer me and my wife's questions.

I have an ascending aortic aneurysm near the aortic root of 4.5 cm. Three years ago this measurement was about 3.8 cm. I'm 24 years old, hypertensive but fairly well controlled. I have a BiCuspid Aortic Valve. I also have various chest pain frequently. The cardiologist wants to "watch and wait" to see if the aneurysm grows. He prefers the word "dilitation".

My questions are


1. In your experience, is an aneurysm of 4.5 CM and the other co-morbidities a good indication for elective surgery?

2. If I have elective surgery to repair my aorta and probably simultaneously replace the valve, how long can a person with the prosthetic valve and dacron graft normally expect to live?

3. Will the new valve have to be a mechanical?

4. Does aortic root diameter/dilitation fluctuate as BMI does? In other words, if I lose weight will my aorta shrink any?

5. I work in a heavy industrial environment. I lift objects that weigh over 85 pounds without assistance. Is this something I should stop doing?

I sincerely appreciate your insight

Aaron

[Mel31107]

Last year, April 4th, to be exact, I underwent surgery for an ascending aortic aneurysm measuring  6 centimeters.  It was discovered during a routine physical in March of 2007, as well as a bicuspid valve with a 1+ leak.  That was a lot to take in all at once.  They replaced the aorta with some flexible material that resembles a mini dryer hose (I can't remember the name of it), but upon inspection of my valve, they opted not to replace it because it was working well.  I don't know your condition, but have they told you if it is necessary to replace the valve at this time?  Anyway, I just wanted to tell you that my life a year later is pretty much back to normal, except that I'm still careful about lifting anything too heavy and I'm on high blood pressure medicine.  The main thing to remember is that when you are recovering please, please, please do what they tell you.  I've heard many horror stories (and witnessed one) about people who try to do too much too soon, and they really hurt themselves.  The incision they give you is not to be taken lightly (mine is 9 and 1/2 inches long).  Good luck to you, and if you want any more information, I'll be happy to tell you anything I can from the post-operation perspective.  

[Mel31107]

Last year, April 4th, to be exact, I underwent surgery for an ascending aortic aneurysm measuring  6 centimeters.  It was discovered during a routine physical in March of 2007, as well as a bicuspid valve with a 1+ leak.  That was a lot to take in all at once.  They replaced the aorta with some flexible material that resembles a mini dryer hose (I can't remember the name of it), but upon inspection of my valve, they opted not to replace it because it was working well.  I don't know your condition, but have they told you if it is necessary to replace the valve at this time?  Anyway, I just wanted to tell you that my life a year later is pretty much back to normal, except that I'm still careful about lifting anything too heavy and I'm on high blood pressure medicine.  The main thing to remember is that when you are recovering please, please, please do what they tell you.  I've heard many horror stories (and witnessed one) about people who try to do too much too soon, and they really hurt themselves.  The incision they give you is not to be taken lightly (mine is 9 and 1/2 inches long).  Good luck to you, and if you want any more information, I'll be happy to tell you anything I can from the post-operation perspective.  

[Annette Quick, M.D.]

THe recommendation is to usually wait til the aorta is >5 cm in size before proceeding to surgery. Life expectancy is variable since the reasons for the dilatation is variable. Ideally it should be mechanical so as to prevent a repeat valve surgery in < 10 years. Losing weight will not shrink the size. You should not be lifting such heavy weights with the aortic dilatation.