I just had this proceedure performed almost 3 weeks ago. I feel like it saved my life. I was at 4.8cm but also have afib. I'm currently recovering and feel great. Im looking forward to returning back to my active lifestyle after another 6-8 weeks. If you have an ascending aortic aneurysm please don't hesitate to get a second opinion if youre not getting the answers that you want! Please go to a highly qualified facility and research you surgeons as well! I feel like I had one of the best surgeons in this country and my proceedure was at one of the top hospitals in the country! Wishing you all a speedy recovery and thank you for putting on a great video and explaining the proceedure so simply!
My ascending aorta is at 4.5cm and it was just discovered, so it may stay that way forever but there's a decent chance I'll need this surgery some day. I appreciate that there's info out here that seems trustworthy and thorough. This is probably the most thorough description I've come across.
Thank you so much for the through explanation. My ascending Aorta is at 4.3cm and I worry about a rupture later in life. I am an active 54 year old male in great shape. My half brother had his rupture and he survived it. My doctor is monitoring the anurism annually. So far, it has not grown any larger in the past few years. I am currently on Metoprolol to slow my heart rate. Thanks again.
Hi doc!! Happy holidays!! First! And guess what?! IM ALIVE! Dr. Grimm saved my life, he truly is outstanding. 14 hours and much worse than we could see on the scans. My tricuspid valve poked a hole in my heart and was bleeding he said I would have been dead in 2 days max if I didn't make it to surgery on Nov. 11. He could look into my aortic valve and actually see my tricuspid through it and apparently your not suppose to be able to do that. I'm so grateful, 9 days in the hospital and I'm home recovering now. I put a 1.5 years worth of work into all leading up for surgery to be at the healthiest I could be and it paid off. GOD IS SO GOOD!! just wanted to let you know. And if anyone else going through similar things I'd be happy to listen or share what I went through. Stay brave my friends. Life is magical.
My Ascending Aortic Aneurysm was 5.8 when I had graft repair. I was initially told to wait until 6. So glad I had I had 2nd opinion. Don’t be afraid to get 2nd or 3rd opinions. It is your life!
Mine is 5.0 as of yesterday. Will see Next week I have no symptoms on a strong athlete. Did you feel any pain or why did you have it? Thank you for your answer and help.
I find it amazing that you know how to do this type of surgery. You take the heart out, put it in a heart lung machine and do surgery on it and put it back in the patient. Dr. you are an amazing person. I thank God for you. God has given you an amazing talent. Thank you for taking time to explain this. God bless you.
@@cardiacsurgerypatienteduca2445 Yes, these men are doing God's work! I love you Doctor, I love all you guys that do this stuff! I had a 15cm ascending aortic Aneurysm!! Talk about the "Widow Maker" as people have said! I am feeling good, Dr. Sanford Zeigler did my surgery and I thank God for him because he saved my life! I wonder if you have ever talked to him? He is very humble Surgeon and that really eased me when I had mine done. I had it done down at MUSC (Medical University of South Carolina). Well sir this video is excellent and I enjoyed it. Take care and God Bless you sir!
Incredible explanation. My friend just had a pulmonary aneurysm. I’m thanking God for his recovery. When you watch the video, you see he just overcame a lot. 🙏
I am 59 yrs old with high blood presssure. I am also under lots of stress, fear and anxiety. Mine was discoverd after admitting for high blood pressure. Its at 4.3cm. the doctors told me, i dont need to worry about it now. But, with high blood pressure, anxiety and every day life in general, how could you not? These are symptoms that can exceed the growth. Everyone in here who has gone through this disease and has revovered! May god continue with his blessings on you. Everyone who is currently facing to deal with it, lets continue to pray and have hope that YOU too, will be ok. Just keep an eye out and try to find the best cardiologist to monitor it. When surgery time comes, pray for your recovery. God does answer prayers🙏
I am 61, healthy, with a aortic root dia at 3.8cm, but I was told, for me, I am simply on the "outer limits of normal". This was pointed out to me from a CT scan a got to get my calcium score (which is at 0!) At just 3.8cm, was told this is NOT an aneurysm, simply mildly dilated. This was confirmed with a follow up CT scan 1 year later showing it is stable and not growing. Just had a echo last week and after 7 1/2 years, still at 3.8cm. blood pressure is normal (115/76). Was told I should not have any worries long term, but will follow with echo every 3 years or so just to be safe!
My cardiologist never explained to me what this Dr. is doing in this video. There should be a law for all cardiologist to explain to their patients what is Ascending Aorta Aneurysm and its consequences because life or death matters.
I had the bental procedure 18 months ago , I had a bicuspid valve which was replaced by a mechanical valve and new ascending aorta fitted because of an aneurysm , I have found recovery tough but was so glad to have this done , my symptoms were breathlessness and mild chest pains , I was struggling for air after activities.
Hi Dave, glad that you are recovering well. Im 49 yo, I have bicuspid valve and aortic aneurysm too at 4.9cm. Was your surgery done to rectify both issues at one go or it was done separately? Wishing you best of health.
@@syamharris I had both done in the same procedure ( Bentall procedure) I had severe aortic stenosis and my aneurysm was 5.5 cm. I am now taking warfarin for life because of the mechanical valve and have found no issues with this and I am 62 yrs old. My son had Aortic valve stenosis when he was a child and had open heart surgery at age 7 , fortunately he didn’t need a valve replacement and he’s now a very fit at 33 yrs old. I hope all goes well with you and try to stay positive, take care and if I can help in any way just ask a question 👍
I was born with a bicuspid aortic valve and on 6/16/22 I had my ascending aorta and aortic valve replaced. It was brutal. Good luck to anyone needing surgery, you can do it!
My brother-in-law just had surgery for ascending aortic aneurysm. The doctor said their was complications when they started to attach the aorta to the valve. He said it started to tear like tissue paper causing them to have to replace the valve. I don’t understand how they didn’t know ahead of time that he had such thin tissue. The surgery took longer than expected resulting in his right side of heart not functioning. They put him on an Ecmo machine. It’s been two weeks and he hasn’t woke up yet. The doctors say that it’s because his kidneys failed and his liver function is getting worse, therefore the sedatives may still be in his system. They are giving him a slim chance to recover.
I'm at 5.1 and having my ascending aortic aneurysm repaired in May along with a MV repair and ablation for Afib.. This video helped me understand what I'll be going through. Thanks..
I have been complaining about feeling unwell, palpations, high heart rate, chest pains. Well something happened to me to where i almost passed out the other day at work. I was taken to the ER and the doctor told me i had mild prominence of ascending aorta. Apparently it has been seen on previous x-rays but i was never told that was what it was. The doctors always say that they have seen something but it is nothing to worry about. So apparently ive been living with this for some years and feeling crappy for a while. So Monday i make an appointment with a cardiologist. I am a 52 year old female and i am scared. Thank you for thoroughly explaining the issue and the solution.
Hi, sorry for the delay. I'm glad they found the aneurysm. I hope the cardiologist explained that the aneurysm is not causing your symptoms. Please make sure your cardiologist refers you to a Cardiac surgeon as well. Good luck
My primary physician suggested that I get an ultrasound of my heart at age 66. No symptoms but she felt that my continued vigorous workouts could contribute to a dilation as the expanding ascending aorta gets less supple with age and may gradually expand. That saved my life. Dilation was very significant, and, on first annual follow-up, the subsequent ultrasound showed that a dissection of the inner wall had occurred but had clotted. ‘had the repair on an expedited basis a week later. Doing great 3 yrs post-op. So discuss getting an ultrasound, even if asymptomatic, with your primary.
Thank you for this very informative video Dr. Lemaire. My G.P just scheduled for the scan. I have to admit I was a little worried at first, but after watching your video I feel much better about it. You have done a great service with this video. Thank you for being so professional, informative, and for speaking on a level that a layman, like me, can understand.
Mine was found incidentally when CT done for pulmonary embolism- that was 7 years ago at age 47. I have no family history and never had high blood pressure. Each year CT is done and it has remained stable at 4.3. Hopefully never need surgery!
Im 42 i need this done and severe aortic valve replacement. Ill find out the game plan from doctors this thursday. Sure ill be fine im a big optimist. Just want it done and over with. Thanks for video good to get a idea of whats happening. update: I got a surgery date im excited nov 12th is gonna be done. These symptoms are so bad. Shortness of breath now coughing. Pain in stomach.
I'm exactly one month shy of my 9th REbirthday,; 8 years and 11 months ago, I had the triple-A repaired with a metallic device, including a metallic valve. Because of this new hardware, I am on a very high dose of blood thinner medication. The aneurysm was dangerous enough to have caused a thoracoabdominal dissection, going from my heart all the way down to my right femoral artery; luckily, it did not "leak" and the blood stayed in the aorta... but it IS a residual dissection that is still in its altered state. The surgeons said that they did not even attempt to repair the dissection because it would have extended the emergency surgery that took eight-plus hours to repair the aneurysm and would have killed me. So, I live - somewhat precariously and often doubtful - with the residual dissection. By the way, John Ritter and Alan Thicke both died of aortic dissections just hours after experiencing the extremely painful and ultimately final symptoms.
Hi Dr. Lemaire: My aneurysm was found by accident in 2018 when I had a cardiac CT done after an episode of chest pain. (I had a chest CT in 2015 for something else and the aneurysm wasn't there.) My Ct was negative, all coronaries wide open, but they found the aneurysm. I've had a couple of echos and cardiac CT's done over the last 3-4 years and it has grown from 3.7cm to 4.5cm (this July). I recently started taking BP medication as bp was elevated. Currently on Losartan 50mg, checking BP every day, going to see my cardiologist on 10/3. I'm 70. My aneurysm is in the area of the sinus of Valsalva. I live in a small mountain town, about 1 hr from a big city. I'm a former cardiac nurse, and as far as I know, there are no surgeons nearby who frequently do these types of aneurysms, esp. in the area I have it. For me to have surgery, I'll probably need to go to Los Angeles. My question is at this point, should I have a consult with a cardiac surgeon? Would it be beneficial to me to start seeing a surgeon now in case it gets larger, or I develop issues? Thank you!
Hi, sorry for the delay in responding. I would advise that you meet with a cardiac surgeon now for several reasons. First, it's always better to establish a relationship with a person who may potentially operate on you. Second, it will allow you time to determine if you trust the surgeon and like him/her. Third, it will give you time to discuss the long-term plan (surgical options). At 4.5cm, an aortic root aneurysm, which is what it sounds like you have, you don't need surgery right now. I suspect if your aortic valve is working fine, you won't need surgery until the aortic root gets over 5cm. Now, if your aortic valve starts to leak (aka aortic valve regurgitation) you may need the surgery sooner. There are very good aortic surgeons in LA. If you need a recommendation, contact me directly at www.cardiacsurgerypatienteducation.com. I suspect your cardiologist knows good cardiac surgeons as well. Good Luck.
Thank you for explaining this. My dad just had his aortic aneurysm fixed and had to be put on bypass to repair the leaking aneurysm. His was at 5.2 cm. I’m guessing his was part of the descending part of his aorta; as the surgeon stated he fixed the short part of the candy cane. Thank you so much for explaining this more in detail.
@@cardiacsurgerypatienteduca2445 he’s doing very well for the risk and the 50/50 mortality rate he had coming out of it. It’s just dealing with the aFib now. He had surgery Thursday and should be coming home in a day or two.
Thanks Doc.... 63 y.o. ...Just clocked a 4.3 and thank God we like in the 3rd millennium!! June will get more details... Also I have a lot ... A LOT ... Of friend who got heart attacks while bench pressing .. ironically, I couldn't bench lately because of a pinched nerve in right shoulder... Take care and thanks to all for giving me a little comfort for available options .. 😊
I just had a CT yesterday for a lung cancer screening and they discovered that I have an ascending aortic aneurysm that is 4.8 cm. I'll be receiving a referral for a cardiac specialist but I wanted to do a little googling to find out more and came across this video. Thank you for explaining it so clearly and concisely. You're quite good at this.
Thank you for the nice comments. Keep your blood pressure controlled and get a well experienced cardiac surgeon who specializes in aortic surgery to follow you. Hopefully with good blood pressure control, it doesn't grow. Good luck!
My ascending aorta aneurysm is 4.5cm. It was discovered pre-operation for bile duct cancer resection in July 2019. Multiple CT scans for oncology treatment show no increase in size since original diagnosis. I guess I'm lucky to be cancer free for 4.5 years as well as the aneurysm not enlarging! 😊
Excellent description, doctor. My ascending aortic aneurysm is at 4.8 cm. It grew from 4.6 to 4.8 cm in one year and I'm 67 years old, in very good athletic shape. I'm going in for a CT scan on 4/3/23. Seven months ago my ascending aorta was at 4.8 cm. I am planning on an Atlantic passage with my sailboat, so this heart issue is definitely a problem. I just want to get the surgery over with as it has grown from 4.4 cm to 4.8 cm in less than two years.
Hi, I completely understand your concerns and the desire to get this taken care of ASAP. I have had patients who requested the surgery before 5.5cm however never before 5cm. I'll defer to you and your doctors. I strongly recommend that you select a cardiac surgeon who does this all the time. Good Luck!
@@cardiacsurgerypatienteduca2445 what is the normal rate of change? Mine went from 4 to 4.5 in 5 years (age 53 and now age 58). Is that slow, normal, or accelerated? This news is less than two old for me, I'm still a bit rocked by it.
Bravo Dr., Lemaire, you explained this very well, and much more thorough and informative 6 minutes than many others I watched prior to finding your tutorial. Guess I'm in the same boat and awaiting a surgeons consult after a recent CT scan. Thank you for providing this and answering so many questions from the audience. I had hoped this was not a major surgery but obviously it is not. Oh well, damn the torpedo's... after a second opinion of course.
Hi, I'm sure you will do well. I want to be clear if done by a surgeon who does this all the time, the surgical risk are low. Please get a second opinion but also get an experienced surgeon. I'm sure you will do well. Good Luck!
@Cardiac Surgery Patient Education Where are you located? And how much does a ultrasound or CT Scan cost, cash out of pocket, no insurance? For an Abdominal Aortic Aneurysm?
Thank You Dr Lemaire. I found your video fascinating and informative. I've been advised that I have a small leakage in my A valve (not fully closing!) I'm reluctant to have surgery. Some years ago, I attended two bypass operations at different hospitals (on the same day) and actually held a heart in my hand during one procedure. It was the most amazing day of my life - thus far and excluding my wedding.... On both I was suited and booted. I've been wondering if, with today's science and technology, we may be able to effect a repair without surgery. Probably not but a rotary saw opening up my chest seems archaic and invasive. I guess for now I'll live with it. Thank you again. John Carroll (jayceemusic)
Hi John, Thank you for your comments. If you were told, you have a small aortic valve leak, its' possible you may never have to have surgery. If you do require surgery there are multiple less invasive options to address your aortic valve issue. First, there are minimally invasive surgery (thoracotomy and not sternotomy). The incisions are smaller. Second, there are percutaneous options in development for the repair of the aortic valve or replacement but this will not be available for a few years. Finally, I understand why you are concerned about traditional surgery with your chest being opened, however the outcomes of these procedures are very good. Patients have been having open heart surgery for decades and the results in the correct hands are excellent. Good Luck!
Thankyou for this I have a 5.5 cent aneurysm and currently waiting for an app to discuss when an op will be done. Mine is thoracic Also have an abdonimal one which is 3cm and are goong to monitor. Your explanation was extremely informative and easy to undestand. For that i thankyou so very much.
I appreciate your comments. I would definitely speak with a Cardiothoracic surgeon soon who is very experienced in this surgery. You meet the requirements for surgery right now. The success rate of the surgery electively is very high in comparison to if the aneurysm ruptures. Good Luck!
Hi Dr! I want to congratulate you for the clear and helpful explanation for this condition. I my mom just had this surgery at some hours ago and there is some blood leakage coming out, it could be coming from the chest pressure from the process of wake up. She is still out. Is this abnormal?
When the graft gets put in, what will happen in the aspect of contractility function of the ascending aorta? Or is there enough pressure generated by contraction of the LV that it won't really affect BP if the graft part doesn't contract down?
Wow! Great tutorial, I want you for my 4.7cm TAA that was discovered during my knee surgery pre-op. Waiting for the next echocardiogram to see if it's progressing; hopefully not! Enough about me; you have a great speaking talent and articulation!
Thank you for the comments. I hope your aneurysm never grows and you don't require surgery. Keep your blood pressure well controlled. Make sure you have a cardiologist and heart surgeon seeing you at minimum annually. Take care.
@@cardiacsurgerypatienteduca2445 how much will losing weight help to prevent growth from from occurring and/or worsening the situation? I noted that you mentioned lowering HBP as well . I’m starting to take away meat from my diet as well
@@dwillmayne5516 Thanks for the question. Losing weight could contribute to lowering your blood pressure and that will improve the situation. The critical aspect is keeping your blood pressure controlled. Personally anything that will overall improve your health will improve the situation.
Fantastic and easy to follow presentation for the average patient such as myself. I am not a Marfan patient. My genetic connective issue is ehlers danlos. Thanks .
Dr Anthony, thank you for a very clear explanation for us laypersons. I’m 63, had CAC done in March of 2023 with a score of 4.76, however an asc aortic aneurysm was found that was 4.2cm. My cardiologist did not say anything to me! And I happen to be going through my report from 2023 a couple of weeks ago when I found the AAA result!!! I have been on keto diet for about one year and I decided to get another CAC which I had two weeks ago. My CAC score is now 15 but the AAA is 4.1cm. 0.1cm smaller that last year. I don’t have insurance and tight on finances, so I want to ask you if I should worry about my AAA at 4.1cm? I’d really appreciate your feedback!!!!! Thank you very much!!!
I appreciate the question. I would state that an ascending aortic aneurysm of 4.1 or 4.2cm will most likely not grow to the 5.5cm however, it still needs to be monitored. By the way, aneurysms don't get smaller so the 4.1cm that was just pointed out is most likely a variable based on the person reading the CT scan. Radiologists can measure the same CT scan differently. Either way continue to monitor. Keep your blood pressure controlled.
Our daughter has Turner’s syndrome and has a bicuspid aortic valve. Her aorta was perfect until we put her on Norditropin (growth hormone) and it was discovered after a year that she had a mild aneurysm. It was written off that it had anything to do with the GH. We continued using them. At her echocardiogram a year later they said it went from mild to moderate. Still rejected the idea that Norditropin had anything to do with it and they highly recommended continuing using it. Finally, due to a global shortage we opted to quit using it and at her last echo it was recommended that she have a sedated cardiac MRI because her aorta looked different. I am confident there is a correlation, as now her Z-score is 5.29 and the aneurysm is classified as “severe”, per the radiologist’s analysis. Our cardiologist has yet to return our calls or schedule anything, even to review the results. To go from mild to severe in a pediatric patient with normal BP seems frightening and that surgical repair is imminent. How would you recommend we proceed?
Hello Dr, I had a heart operation in February and they left the top of my sternum open, I am now having a quiver going down the center of my chest and a pain that comes and goes in my right hip joint, at my aorta. What can I do. The doctor says there's nothing wrong with my heart
Thank you Doctor you explained everything well! My brother has an enlarged aorta and may have to have surgery! I'm scared for him! He has Central sleep Apnea really bad and sleep paralysis also. He has Diabetes which is severe and he's considered a High Risk patient! I'm scared for him.
Hi, please make sure your brother sees an experienced surgeon. Those are important risk factors but an experienced surgeon should get him through it. Good Luck!
Best explanation I’ve heard. Clear anatomical description and function of the heart & aorta. Easy to visualize and understand. Realistic. Thank you Dr so much! What is your name?
I'm interested about the gortex graft. When you sew it in and it is in position will there will a weakness at the 'sewing line'? I will probably be needing this surgery at some point. Also, after the op do you still get screened to ensure everything stays in place? How common is it that the anuerysm develops again even with a graft? Thank you for your very helpful video.
Hi, I wanted to clarify that there are different types of grafts and actually the most common type of graft is the Gelweave graft not Gortex which I mentioned. Anyhow, you are correct that the "anastomosis" is the most important part of the connection. I don't want to use the word "weakness". Second, the aorta that is left behind can grow to become an aneurysm but what you remove obviously is gone. The patient's do require observation or surveillance after surgery to make sure that the remaining aorta doesn't grow. Its hard to say how common it is that the re maining aorta becomes an aneurysm. I haven't seen the studies but I don't expect it to be high.
I have one, it was found 2 years ago when I had a massive heart attack, they had to put a stent in my RCA and found it then, it was 3.9, have not had it checked since, but I do have an upcoming appt to do just that.. Never have any pain... My mom had one too, almost the same size and hers never grew past 3.9 and she lived to be 83 years old and died from sepsis..
Hi, sorry for the delay in responding. I'm glad that your mom's aneurysm never grew more than 3.9cm. I would strongly recommend that you keep your blood pressure controlled, follow with a Cardiothoracic surgeon, and a cardiologist. Good Luck!
Can I have weight loss surgery if I have a mildly descended aorta? The aortic root is grossly normal in size at the sinuses of Valsalva. The ascending aorta is mildly dilated. Ascending aorta measures 4.1 cm@ 3.1 cm distal to STJ. This was an echocardiogram. But they also said that it was hard to interpret because of my weight. My BMI is 64. So do you think elective surgery would be safe? I'm a 56 year old woman. I have also had a heart ablation 2 years ago.
Hi, Sorry for the delay in responding. At 4.1cm, you should be able to have weight loss surgery. The risk of rupture at 4.1m although not zero is relatively low. I would personally communicate your concerns with your abdominal surgeon and anesthesiologist. Personally, I think you will benefit from the weight loss surgery given your BMI. Good Luck.
Very good explanation I actually have aortic ascending aneurism very big ! But I was told that it would be risky to be operated I could be paralyse ! So I decided to reject any operation and see what will happen ! So far I am ok but not perfect ! I believe that only GOD can save me !
Hello, About 4 months ago I was informed by a Cardiac surgeon that my ascending aorta was 4.4 cm and not in need of surgery until 5.0 cm. I also require surgery for mitral valve prolapse. Do you recommend aorta surgery @ 4.4 cm concomitant with MVP surgery? Can the comorbidity surgery be done robotically? I am 70 years old w/ high blood pressure and mild shortness of breach but workout 3 days a week. Will most surgeons allow this type of surgery? Surgery will be done at Scripps Hospital in San Diego in a couple of months.
Hi, Sorry for the delay in responding. I'll address your questions, one at a time. First, at 70yo, it's probably unlikely that your aneurysm will get to the 5.5cm indicator for repair. I think you need to clarify with your surgeon what size indicator he/she is using for surgery. You mentioned 5.0cm, is that because you have a bicuspid aortic valve? The size indicator is normally 5.5cm unless there are other issues. 2. If you have a bicuspid aortic valve and are having open surgery (sternotomy) then it's possible that the aorta can be repaired at the same time as the mitral valve. There are more issues that can be discussed than I can say on a YT channel. Please either contact me directly through my website or office to discuss. 2. The mitral valve can be repaired robotically but not the aneurysm. 3. You asked if "most surgeons will allow" this surgery. I'm not sure I understand what you mean? Allow what? Perform the mitral surgery and leave the aneurysm. Please clarify. I personally think the indication for repairing the aneurysm at 4.4cm depends on several factors. If you are getting a minimally invasive mitral valve repair, most surgeons wouldn't repair the aneurysm at 4.4cm but if you have a bicuspid aortic valve then the criteria to repair the aneurysm is 4.5cm so some surgeons would repair it. There are more to say but contact me if you want to discuss further.
hello dr. thank u for ur very nice presentation. I'm 56 yrs, was actively working as an RN, I had an emergency life saving aortic valve repair(bovine)post a type B dissection all the way till the rt. femoral artery 1 yr ago. Unfortunately had uncontrolled HTN that I didn't take seriously. Please my questions are: 1- how long would a bovine valve live? 2- what's my life expectancy? 3- will I need to fear needing a kidney transplant in the future , have some microalbuminuria?
Hi, Sorry for the delay in responding. To address your questions. 1. A bovine valve will usually need to replaced in 10-15 years. 2. In general, if you are compliant with your medications and following up with your doctors, you should have a normal life expectancy. Of course, as you know, its not as easy as most people think to be compliant. 3. I wouldn't worry about the need for a kidney transplant, I would be focused on keeping your blood pressure controlled.
Hi, Currently Stent grafts are not available to repair ascending aortic aneurysms. One of the main issues is creating a graft that will not occlude the coronary arteries. There are several companies working on it and so I believe in the future there will be an option to treat ascending aortic aneurysms with stent grafts.
Last year I was found to have an ascending aorta aneurysm of 4.5 cm and bicuspid aortic valve. Cardiologist did not seem concerned. Yet by what you are saying I am at high risk for rupture ~ I will be seeing a new cardiologist in July and get a second opinion. Thank you for your informational video. One question: " Is there a risk to fly long distance with this condition?"
I sincerely apologize for the delay in responding. First, there is no issue or risk with flying with an aneurysm. Second, to address your question. As long as your bicuspid valve is functioning well, I would not electively replace your aortic valve or aneurysm. If your aortic valve however was not working well, which most likely would be aortic valve stenosis, then if you had surgery, the treatment would be an aortic valve replacement and aneurysm repair. I apologize for not being more clear but you wouldn't replace the bicuspid valve if its working. I also wouldn't just fix the aneurysm at 4.5cm. If the aneurysm does starting increasing in size, especially greater than 5cm, I would at a minimum see a heart surgeon. I would make sure that your aortic valve and aneurysm are being checked yearly with an echocardiogram and CT scan of the chest.
Hi doctor! Thank you so much for your informative video, I am 24 years old and got diagnosed with 4.5 aortic root aneurysm, I have a bicuspid aortic valve with mild regurgitation. The diagnosis was made just by an echo. My doctor said that their is no need to do a CT scan or mri. Also, they want to monitor me just by echo. Is CT scan or mri essential in my case? Thank you in advance! Regards
Sorry for the delay in responding. I personally believe that a CT scan of the chest is important to serve as a baseline for your aorta. I would personally continue getting an annual CT scan of the chest and echo. The ECHO is to look at the aortic root, and aortic valve. The CT scan of the chest is to look at the ascending aorta, and remaining aorta.
Great question. Currently, ascending aortic aneurysms cannot be repaired endoscopically because of several reasons. First, because of the presence of the coronary arteries there has always been a fear that the grafts with occlude or block the coronary arteries. If that occurs that can be fatal as the heart would not get blood. Second, there has not been grafts created for the ascending aorta that have been FDA approved. Now, there are some off label grafts that can be used but to my knowledge, nothing has been approved. I suspect in the future there will be grafts for the ascending aorta but currently none there are commercially approved exists.
Thank you Dr. Lemire. I just found out that I have a 4.5cm ascending Aortic Aneurysm. My brother and sister (in Asia ) also have ascending and descending. I believed this is part our family's gift. Now , I am wondering what kind of Dr. I should look for to monitor my aneurysm in New York. I am 74, live in Nassau Long Island NY. I try not to have surgery, just like my brother he still hanging around there. I need to know how to avoid make it worse, so I can live longer. I appreciate that anyone can share this kind of experience.
I have a question, for so long I've been having issues with numbness in my feet. Pain in my legs. Numbness in my face passing out very irregular, heartbeat and sweating When that happens. I found a chart that was from a doctor that I saw back in 2017, they did an EKG and found that it was abnormal. Then they did an ultrasound of my heart and evidently it found that I had atrial septal aneurysm! Nothing was ever said to me about this. I never saw the doctor again because when I went to schedule an appointment they were no longer there. I was made aware of this at a neurology appointment because the numbness in my feet is so annoying. They mentioned if I was aware that I had that show up on an echocardiogram. And I said no. I had no idea. I seem to have a really hard time finding a good doctor, I don't go to the doctor very often because of that reason. Is starting to be very concerning to me because I'm not sure if that is something that I have to be concerned about, but given my symptoms that I've had and do have from time to time, I'm wondering if that is something serious and how in the world did that happen? I would appreciate any input that you have. Thank you
Hi, sorry for the delay in responding. I think you need to sit down with a good medical doctor, and cardiac surgeon. There are many reasons for numbness in your feet and I don't think its related to the atrial septal aneurysm. Please contact me through my website and I can help refer you to a good cardiac surgeon in your area.
My brother had a 5.1cm aortic aneurysm at the root area that dissected and he died. Since there is some family history of this, I had been found to have a 4.6cm aneurysm at the root area and they suggested I get it fixed. Always wondered if we jumped the gun there, but it is done. Being an active person, ever since operation I get an uneasy pain or pressure in the chest and back when my heart rate peaks during exercise, this always happens. Stress tests, etc, have been ok. Ever hear of this effect? When hiking with friends I seem to be last one up hill, am 62. I always wonder if this is just some residual pain due to clamshell effect of having chest opened.
Sorry for the delay in responding. I personally think that operating at 4.6cm is a little early however since your brother died, I can understand why it was recommended that you have surgery earlier than the actual size indication (5.5cm). Regarding the chest pain you're having a lot depends on how long ago was your operation. If its been many years since your surgery, I would be more concerned. Although you had a stress test, sometimes those are wrong (false negative). A cardiac catherization to look at your coronary arteries is the best test. I would speak to your cardiologist about this. I would also go back to your cardiac surgeon to discuss. Good Luck.
@@jamesreeves9740 I had the operation in May of 2013 and by October of that year I was hiking in Yellowstone. Took some time though to get back up to speed on activities.
Sorry for the delay in responding. There is no medical cure for an aneurysm. You can treat these medically with blood pressure control but the ultimate treatment is surgical if it gets to the target size. You can always decide to not operate which has its own consequences but this would require a long discussion with the heart surgeon.
This week I was diagnosed with an ascending aorta aneurysm, 4.2. I am curious if anyone has had this type of aneurysm repaired using a minimally invasive procedure?
Hi, I apologize for the delay in responding. There are certain surgeons that can perform this operation through a minimally invasive approach. Hopefully you will never need the operation. At 4.2 cm that is a small aneurysm . I would strongly recommend keeping your blood pressure controlled, and get a referral to a cardiac surgeon. Good Luck!
Please can you tell me if my husband who has a 5cm asending aneurysm just found out, moderate aortic stenosis and bicuspid valve can be operated on? History of submarachroid hemorage small TIA and severe c.o.p d , its not looking hopeful 😢
Hi, I appreciate the question. First, as of right now, your husband does not have an indication to have surgery now. His 5cm aneurysm doesn't meet the 5.5cm aneurysm. His moderate aortic stenosis does not meet criteria for surgery. Now, his bicuspid aortic valve does put him at a higher risk of the aneurysm growing and potentially an aortic dissection. I would STRONGLY recommend that your husband gets seen by a very experienced cardiac surgeon. The subarachnoid hemorrhage puts him at a higher risk for intracranial bleed but if there is enough time between the diagnosis and surgery, the risks goes down. The severe COPD is another concern for possibly not extubating after surgery. Your husband needs several consultants (Neurologists, Pulmonologist, cardiac surgeon) to optimize his condition and make him a better candidate for surgery. I would not give up on your husband. Finally, I would ask your husband to please speak to his doctor and get the consults that you need. Please contact me directly through my website for referrals for experienced cardiac surgeons in your area.
Sorry for the delay in responding. Yes, this surgery can be done minimally invasively. Please look into doctors in your area that can do that. You may have to go to a center that is a little farther from where you live. Take care.
Hello, I have a dilatation of my aortic root at 4.1 and I also have right bundle branch block. My question is whenever this goes to surgery, will the RBB be a deciding factor of mortality with open heart surgery to fix the aneurysm? Thanks
I apologize for the delay in responding. First, depending on your age, there is a chance that you may not require surgery. However, the presence of a Right Bundle Branch block is not a deciding factor in having surgery. The 3 critical factors are (1) Size of the aortic root, (2) Presence of aortic valve regurgitation, and (3) the presence of symptoms.
Thank for this well informative video. I am at 4.4x 4.5 and I cough all the time. The cough is so bad it wears me out. I have seen every doctor ENT, Lung, allergist. Will Ascending Aortic Aneurysm cause a cough?
I'm sorry your dealing with the cough. Its unusual for an aneurysm to cause a cough unless it was extremely large and perhaps irritating surrounding structures. The size of your aneurysm doesn't seem that big. If you really believe its the aneurysm then get a CT scan chest with contrast and have the radiologist determine if the aneurysm is compressing any structures. Good luck!
Thanks so kindly for the explanation. Wondering if you perform EVAR for a diameter of 4.9cm on 78 years in an excellent shape? Thank you for your response.
Hi, Sorry for the delay in responding. I am a cardiothoracic surgeon and I do not perform EVAR for abdominal aortic aneurysms. I do perform TEVAR on Thoracic aortic aneurysms. I am not as familiar with abdominal aortic aneurysms but I believe the size criteria is 5.5cm for aneurysm repair. PLEASE confirm this with a. vascular surgeon. Good Luck!
I am more relaxed now as I will meet with my cardiologist today.. I don’t want to give up my 2000 yard swim on almost daily basis I used Afrin spray and Sudafed pills for nearly 40 years that contributed in raising up my blood pressure..I believe it affected my high pressure negatively. I hope it’s not too late as I stopped cold turkey..Thank you again.
Thank you for this, I just learned yesterday I have a 4.5cm ascending aortic aneurysm. My daughter has Ehler Danlos syndrome so my doc is sending me for genetic testing to decide what's next. I'm fit as any 58 year you'll find, I'm ranked #1 in the world in the Spartan DekaFit Mile 55-59 age group, so this rocked me and I'm trying to learn as much as possible as fast as possible, I've done everything right in life when it comes to health, I can't believe this. Does having Ehler Danlos change the equation that much? And if I can try not to "strain" too much, is it risky to compete in hybrid sports like Hyrox and DekaFit (kind of like crossfit with 8 1000m sprints between workout stations)?
Hi, sorry for the delay in responding. If you have any connective tissue disorder you generally will have an aorta that grows faster than someone who doesn't have that disorder like Ehler Danlos syndrome. I would say from a patient perspective I would (1) confirm the diagnosis, (2) keep your blood pressure well controlled, and (3) get referred to a cardiac surgeon (experienced in aortic surgery). I would say that it's ok to work out but as you stated, I would try to limit activities with lots of straining such as power weight lifting. Your aorta is relatively small at 4.5cm and you have no indication for surgery at this time. There is a good chance that you will never have to have aortic surgery.
@@cardiacsurgerypatienteduca2445 I wish I could do something to show you my gratitude, your reply is the best news I've heard and gives me hope....thank you so much...the world needs more people like you....thank you again.
I am 48 f I have a 3.5 cm distal? AAA. The aneurysm was found in Feb 2022 and I have my next ultra sound in April. Is it true that AAA are more aggressive in women and I have a higher chance of rupture at a smaller size and dying?
Hi, I apologize for the delay in responding. I'm not certain I know where your AAA is. If you are referring to the ascending aorta then a 3.5cm is relatively very small. As I mentioned in the video the indication to operate is 5.5cm so you are very far away. Similarly, if you are referring to an abdominal aortic aneurysm, it's still considered very small. To answer your question, I do not believe aneurysms are more aggressive in women. The size criteria for women is the same but I suspect that since most women are smaller than man, that an aneurysm may rupture at an earlier size relative to the smaller women's size. For example, a 4.8cm aneurysm in a 5ft size woman would be more likely to rupture than in a 6ft man. Ultimately, I think women may rupture at a smaller size but it doesn't happen all the time. I strongly suggest that you find a surgeon that you trust and get close follow up.
Im 70 years old, had a life of sport (bicycle racing, with at some point a vo2max of 73), nor mal blood pressure now, 79 kgs and 1.82, no cholesterol problems. But chest pain and shortness of breath while cycling and walking at a brisk pace. A lung ct scan revealed and ascending aorta of 4.7 cms. What to do. I feel im too young to just give up on all sport activities, especially the bicycle. Id be grateful for any advice!
Hi, sorry for the delay in responding. An aneurysm of 4.7cm is most likely NOT causing you to have chest pain and SOB. Aneurysms classically only cause symptoms AFTER they rupture. At 4.7cm, you do NOT meet criteria for surgical intervention. I would STRONGLY recommend talking to your cardiologist to work up the TRUE cause of your symptoms. I would find the true cause of your symptoms before aggressive exercise. Once again, without more information, I see no reason for surgery.
@@cardiacsurgerypatienteduca2445 thanks very much, don't worry about delay. I don't expect instant response! 😏 I've been to the cardiologist a few days ago, he suggested going to better specialist in Bangkok (I'm in Hua Hin, a smaller town). I don't know about that. Might do that later. In the meantime I'll take up cycling again, see if that will improve the condition. And I'm doing it gently. I'm not going to it like I did in the early 80s. All those years of training and racing have taught me to recognize how my body reacts. Heart and lungs are not the same as legs ... I record my modest activity on Strava: Freek Faro.
Wonderful video sir. Thank you. I was having chest pain after only swimming 2 laps but I could do 6 miles on the treadmill, and go skiing at 12,000 feet, with no problems. Saw a cardiologist and was measued at 4.4cm in Oct, with a tricuspid valve. I have no other issues with my heart, low risk factor for lifestyle and no family history. Doc put me on Lisinopril and I just had another echo and it showed only 4.1cm this time, and the technician spent 40 minutes looking at it closely. Question: is it possible that the medicine reduced my BP such that the aneurysm shrunk or do you suspect the 1st measurement of 4.4cm was just a little off? Thanks.
Great question. In my opinion, the aorta does NOT decrease in size. You have to make sure that you are comparing the size of the aorta with the same studies. A CT scan of the chest with contrast is the best test to measure the size of the aorta. An echocardiogram is good but not the best test. I suspect the 4.4cm size wasn't accurate however, what was the test that measured the 4.4cm? If it was a CT scan of the chest then perhaps the 4.4cm was a technical error by the radiologist. There are so many possible issues, the bottom line is the CT scan of the chest is the best and compare the size of the aorta with the same studies.
@@cardiacsurgerypatienteduca2445 Thank you for your reply. Both tests, 1 done in early October and the 2nd done last week, were done with an Echocardiogram. My doc ordered a PET Stress Test but insurance denied it and approved a Nuclear Stress Test as a sunstitiute. Also had that last week and have appt today to review findings. My carotids have some plaque but doc said not enough to have to have procedure to clean it out. Wondering if obstruction in Carotids can cause the aneurysm in the acsending aorta?
I was recently told i have a dilatation of the ascending aorta. 2.9 cm I also have hypertension, high pressures on the left aide of the heart. Do i qualify for the surgery now?
Thank you for the question. The answer is no. The standard clinical size for surgery is when the ascending aorta is 5.5cm. There are some exceptions. Please review the video. Thanks
Hello Doctor, My family member was just told his abdominal aorta aneurysm has grown to 7cm. They want to perform surgery, but he is extremely afraid, and thinks he can control it by controlling his blood pressure. I'm worried because I'm reading that surgery is the only option. He is 58 years old. What are his chances of survival in this scenario? Is the endovascular repair his best option?
Hi, at 7cm I would strongly recommending having the aneurysm repaired. The risk of rupture is very high. I would strongly recommend doing some research and finding a good vascular surgeon who could operate on him. There may be an endovascular repair option. I would try to get this done ASAP. If you want a particular referral contact me at www.cardiacsurgerypatienteducation.com.
Great question. There are currently no FDA approved stents that can treat ascending aortic aneurysms. TEVAR is available for aortic arch and descending aortic aneurysms but NOT currently for ascending aneurysms. The main reason is because there is concern that the stent would block off the coronary arteries.
Are people that workout and train hard at higher risk of rupture? My ascending aorta is at 4.6 cm and sometimes when I’m training I worry about it. It was discovered 4 years ago and initially was 4.5cm so it’s slowly getting bigger.
Hi, Good question, the short answer is that exercise could result in an increase in size of the aorta however, its' hard to say because there is not much research on it. I can say that exercise such as powerlifting can increase your blood pressure which could lead to aortic rupture. I don't know if there is a clear relationship between working out and increasing your aorta. I suspect that cardio work such as running, etc., wouldn't increase your aorta but I don't have definitive proof.
Im 70 years old, had a life of sport (bicycle racing, with at some point a vo2max of 73), nor mal blood pressure now, 79 kgs and 1.82, no cholesterol problems. But chest pain and shortness of breath while cycling and walking at a brisk pace. ECG shows a slight abnormality in the left ventricle. Angiogram shows a minor obstruction (20%) of some artery, otherwise it looked very healthy according to the doctor. A lung ct scan revealed an ascending aorta of 4.7 cms. Could that be the cause of the chest pain and shortness of breath. What to do. I feel im too young to just give up on all sport activities, especially the bicycle.
Hi, There is no "difficult" time to repair however, the size indication for surgery is 5.5cm. Most surgeons don't wait that long though. I would strongly suggest that you meet with a cardiac surgeon to discuss this. There are multiple issues that need to be reviewed. When the aortic root is enlarged the aortic valve will often not work well. Good Luck. If you have additional questions, please email me.
I would love a Cardiologist like him. He is amazing @ explaining all of this.
I am at 4.7 cm. I have got zero good advice besides this video. If you are ready to rock this surgery I feel ready!
I appreciate the comments. Unless you have a special situation, you don't need the surgery at this time. Good Luck!
Great video ! Well done ! Thanks 🎉
I just had this proceedure performed almost 3 weeks ago. I feel like it saved my life. I was at 4.8cm but also have afib. I'm currently recovering and feel great. Im looking forward to returning back to my active lifestyle after another 6-8 weeks. If you have an ascending aortic aneurysm please don't hesitate to get a second opinion if youre not getting the answers that you want! Please go to a highly qualified facility and research you surgeons as well! I feel like I had one of the best surgeons in this country and my proceedure was at one of the top hospitals in the country! Wishing you all a speedy recovery and thank you for putting on a great video and explaining the proceedure so simply!
Thanks for the comments and I'm glad that you've done well.
I had it and the arch done in Apr of 2021 at MUSC. My aneurysm was 14.99cm when it was taken out!!
@@clemsonbloke 14.99cm??? Did I read that right?
@@dwightkeen5160 Yes Sir!
@@clemsonbloke Sounds like everything went well. I'm happy for you. Good Luck with the rest of your recovery.
My ascending aorta is at 4.5cm and it was just discovered, so it may stay that way forever but there's a decent chance I'll need this surgery some day. I appreciate that there's info out here that seems trustworthy and thorough. This is probably the most thorough description I've come across.
Thank you very much. Please make sure you keep your blood pressure controlled. Good luck.
Thank you so much for the through explanation. My ascending Aorta is at 4.3cm and I worry about a rupture later in life. I am an active 54 year old male in great shape. My half brother had his rupture and he survived it. My doctor is monitoring the anurism annually. So far, it has not grown any larger in the past few years. I am currently on Metoprolol to slow my heart rate. Thanks again.
Glad to hear you are doing well. Keep your blood pressure controlled. Good Luck!
Hi doc!! Happy holidays!! First! And guess what?! IM ALIVE! Dr. Grimm saved my life, he truly is outstanding. 14 hours and much worse than we could see on the scans. My tricuspid valve poked a hole in my heart and was bleeding he said I would have been dead in 2 days max if I didn't make it to surgery on Nov. 11. He could look into my aortic valve and actually see my tricuspid through it and apparently your not suppose to be able to do that. I'm so grateful, 9 days in the hospital and I'm home recovering now. I put a 1.5 years worth of work into all leading up for surgery to be at the healthiest I could be and it paid off. GOD IS SO GOOD!! just wanted to let you know. And if anyone else going through similar things I'd be happy to listen or share what I went through. Stay brave my friends. Life is magical.
Great news!. Very happy for you.
Thank you Doctor Anthony Lemaire for a thorough explanation on how to repair an ascending aortic aneurysm.
Thank you for the nice comments. My pleasure.
My Ascending Aortic Aneurysm was 5.8 when I had graft repair. I was initially told to wait until 6. So glad I had I had 2nd opinion. Don’t be afraid to get 2nd or 3rd opinions. It is your life!
Mine is 5.0 as of yesterday. Will see
Next week I have no symptoms on a strong athlete. Did you feel any pain or why did you have it? Thank you for your answer and help.
@@azrak555 I had no pain at all. My aneurysm was found by accident while getting a CT on a completely unrelated health issue. Best of luck!
I forgot to ask you, was it an open heart surgery or EVAR? Thanks again.
@@azrak555 open heart. did a valve repair as well.
I find it amazing that you know how to do this type of surgery. You take the heart out, put it in a heart lung machine and do surgery on it and put it back in the patient. Dr. you are an amazing person. I thank God for you. God has given you an amazing talent. Thank you for taking time to explain this. God bless you.
I appreciate the comments.
@@cardiacsurgerypatienteduca2445 Yes, these men are doing God's work! I love you Doctor, I love all you guys that do this stuff! I had a 15cm ascending aortic Aneurysm!! Talk about the "Widow Maker" as people have said! I am feeling good, Dr. Sanford Zeigler did my surgery and I thank God for him because he saved my life! I wonder if you have ever talked to him? He is very humble Surgeon and that really eased me when I had mine done. I had it done down at MUSC (Medical University of South Carolina). Well sir this video is excellent and I enjoyed it. Take care and God Bless you sir!
Incredible explanation. My friend just had a pulmonary aneurysm. I’m thanking God for his recovery. When you watch the video, you see he just overcame a lot. 🙏
I am 59 yrs old with high blood presssure. I am also under lots of stress, fear and anxiety. Mine was discoverd after admitting for high blood pressure. Its at 4.3cm. the doctors told me, i dont need to worry about it now. But, with high blood pressure, anxiety and every day life in general, how could you not? These are symptoms that can exceed the growth. Everyone in here who has gone through this disease and has revovered! May god continue with his blessings on you. Everyone who is currently facing to deal with it, lets continue to pray and have hope that YOU too, will be ok.
Just keep an eye out and try to find the best cardiologist to monitor it. When surgery time comes, pray for your recovery. God does answer prayers🙏
Thank you for the great comments.
I am 61, healthy, with a aortic root dia at 3.8cm, but I was told, for me, I am simply on the "outer limits of normal". This was pointed out to me from a CT scan a got to get my calcium score (which is at 0!) At just 3.8cm, was told this is NOT an aneurysm, simply mildly dilated. This was confirmed with a follow up CT scan 1 year later showing it is stable and not growing. Just had a echo last week and after 7 1/2 years, still at 3.8cm. blood pressure is normal (115/76). Was told I should not have any worries long term, but will follow with echo every 3 years or so just to be safe!
I think you got good advice and I'm glad that the aneurysm is not growing.
Outstanding explanation, thank you very much for taking the time to make this video for the public viewing.
My cardiologist never explained to me what this Dr. is doing in this video. There should be a law for all cardiologist to explain to their patients what is Ascending Aorta Aneurysm and its consequences because life or death matters.
I wish you the best.
I had the bental procedure 18 months ago , I had a bicuspid valve which was replaced by a mechanical valve and new ascending aorta fitted because of an aneurysm , I have found recovery tough but was so glad to have this done , my symptoms were breathlessness and mild chest pains , I was struggling for air after activities.
Congratulations on your recovery and I'm glad that surgery went well.
@@cardiacsurgerypatienteduca2445 Many thanks and Happy New year to you.
Hi Dave, glad that you are recovering well. Im 49 yo, I have bicuspid valve and aortic aneurysm too at 4.9cm. Was your surgery done to rectify both issues at one go or it was done separately? Wishing you best of health.
@@syamharris I had both done in the same procedure ( Bentall procedure) I had severe aortic stenosis and my aneurysm was 5.5 cm. I am now taking warfarin for life because of the mechanical valve and have found no issues with this and I am 62 yrs old. My son had Aortic valve stenosis when he was a child and had open heart surgery at age 7 , fortunately he didn’t need a valve replacement and he’s now a very fit at 33 yrs old. I hope all goes well with you and try to stay positive, take care and if I can help in any way just ask a question 👍
I was born with a bicuspid aortic valve and on 6/16/22 I had my ascending aorta and aortic valve replaced. It was brutal. Good luck to anyone needing surgery, you can do it!
My brother-in-law just had surgery for ascending aortic aneurysm. The doctor said their was complications when they started to attach the aorta to the valve. He said it started to tear like tissue paper causing them to have to replace the valve. I don’t understand how they didn’t know ahead of time that he had such thin tissue. The surgery took longer than expected resulting in his right side of heart not functioning. They put him on an Ecmo machine. It’s been two weeks and he hasn’t woke up yet. The doctors say that it’s because his kidneys failed and his liver function is getting worse, therefore the sedatives may still be in his system. They are giving him a slim chance to recover.
Thank you! It’s been depressing stressing crying my eyeballs kind of thing. Thanks for the encouragement really helps god bless.
God will give new heart
Well described. Thank you. One year + since my unforseen dissection requiring emergency surgery. Life is short. Life is good.
Glad you are doing well. Please make sure your family members update their personal doctors. Aortic issues run in the family.
Very informative lecture and easy to understand . I wish he were here where we are!
I'm at 5.1 and having my ascending aortic aneurysm repaired in May along with a MV repair and ablation for Afib.. This video helped me understand what I'll be going through. Thanks..
I have been complaining about feeling unwell, palpations, high heart rate, chest pains. Well something happened to me to where i almost passed out the other day at work. I was taken to the ER and the doctor told me i had mild prominence of ascending aorta. Apparently it has been seen on previous x-rays but i was never told that was what it was. The doctors always say that they have seen something but it is nothing to worry about. So apparently ive been living with this for some years and feeling crappy for a while. So Monday i make an appointment with a cardiologist. I am a 52 year old female and i am scared.
Thank you for thoroughly explaining the issue and the solution.
Hi, sorry for the delay. I'm glad they found the aneurysm. I hope the cardiologist explained that the aneurysm is not causing your symptoms. Please make sure your cardiologist refers you to a Cardiac surgeon as well. Good luck
My husband had to have this surgery soon . This really explains it well.
Thank you for explaining this so well.
Very Clear and understandable. My Wife is going to have this done.Thank You!
My primary physician suggested that I get an ultrasound of my heart at age 66. No symptoms but she felt that my continued vigorous workouts could contribute to a dilation as the expanding ascending aorta gets less supple with age and may gradually expand.
That saved my life. Dilation was very significant, and, on first annual follow-up, the subsequent ultrasound showed that a dissection of the inner wall had occurred but had clotted. ‘had the repair on an expedited basis a week later. Doing great 3 yrs post-op.
So discuss getting an ultrasound, even if asymptomatic, with your primary.
I'm glad that everything worked out for you!
Great video. Succinct and easy to follow. Thank you!
Thank you Doctor! Very informative!
Great explanation. Thank you!
Thank you for the super clear explanations!
thank you for your inforantion this procedure.
Thank you for such a clear explanation.
Thank you for this very informative video Dr. Lemaire. My G.P just scheduled for the scan. I have to admit I was a little worried at first, but after watching your video I feel much better about it. You have done a great service with this video. Thank you for being so professional, informative, and for speaking on a level that a layman, like me, can understand.
I appreciate the comments. Good luck with everything.
Best explanation to date thank you 🙏🏽
Thank you Doc for awesome, informative video🙏🏽🙏🏽
Thank you for this very informative video.🙏🏼❤️
Mine was found incidentally when CT done for pulmonary embolism- that was 7 years ago at age 47. I have no family history and never had high blood pressure. Each year CT is done and it has remained stable at 4.3. Hopefully never need surgery!
Read ALL your comments Dr.
Very informative, reassuring.
You are so caring & compassionate to answer all these questions!
Excellent - thank you for explaining the basics so well.
Im 42 i need this done and severe aortic valve replacement. Ill find out the game plan from doctors this thursday. Sure ill be fine im a big optimist. Just want it done and over with. Thanks for video good to get a idea of whats happening. update: I got a surgery date im excited nov 12th is gonna be done. These symptoms are so bad. Shortness of breath now coughing. Pain in stomach.
Good Luck! I'm sure you will do fine. In experience hands, the risk are relatively low.
Great explanation
I'm exactly one month shy of my 9th REbirthday,; 8 years and 11 months ago, I had the triple-A repaired with a metallic device, including a metallic valve. Because of this new hardware, I am on a very high dose of blood thinner medication. The aneurysm was dangerous enough to have caused a thoracoabdominal dissection, going from my heart all the way down to my right femoral artery; luckily, it did not "leak" and the blood stayed in the aorta... but it IS a residual dissection that is still in its altered state. The surgeons said that they did not even attempt to repair the dissection because it would have extended the emergency surgery that took eight-plus hours to repair the aneurysm and would have killed me. So, I live - somewhat precariously and often doubtful - with the residual dissection. By the way, John Ritter and Alan Thicke both died of aortic dissections just hours after experiencing the extremely painful and ultimately final symptoms.
What an excellent video and lecture. I have one of these AAA and it’s being regularly checked. Thank you Doc for the explanation, I’ve learned a lot.
I had this done at Yale in 2020. Aortic valve was repaired too.
Hi Dr. Lemaire: My aneurysm was found by accident in 2018 when I had a cardiac CT done after an episode of chest pain. (I had a chest CT in 2015 for something else and the aneurysm wasn't there.) My Ct was negative, all coronaries wide open, but they found the aneurysm. I've had a couple of echos and cardiac CT's done over the last 3-4 years and it has grown from 3.7cm to 4.5cm (this July). I recently started taking BP medication as bp was elevated. Currently on Losartan 50mg, checking BP every day, going to see my cardiologist on 10/3. I'm 70.
My aneurysm is in the area of the sinus of Valsalva. I live in a small mountain town, about 1 hr from a big city. I'm a former cardiac nurse, and as far as I know, there are no surgeons nearby who frequently do these types of aneurysms, esp. in the area I have it. For me to have surgery, I'll probably need to go to Los Angeles. My question is at this point, should I have a consult with a cardiac surgeon? Would it be beneficial to me to start seeing a surgeon now in case it gets larger, or I develop issues?
Thank you!
Hi, sorry for the delay in responding. I would advise that you meet with a cardiac surgeon now for several reasons. First, it's always better to establish a relationship with a person who may potentially operate on you. Second, it will allow you time to determine if you trust the surgeon and like him/her. Third, it will give you time to discuss the long-term plan (surgical options). At 4.5cm, an aortic root aneurysm, which is what it sounds like you have, you don't need surgery right now. I suspect if your aortic valve is working fine, you won't need surgery until the aortic root gets over 5cm. Now, if your aortic valve starts to leak (aka aortic valve regurgitation) you may need the surgery sooner. There are very good aortic surgeons in LA. If you need a recommendation, contact me directly at www.cardiacsurgerypatienteducation.com. I suspect your cardiologist knows good cardiac surgeons as well. Good Luck.
Thank you for explaining this. My dad just had his aortic aneurysm fixed and had to be put on bypass to repair the leaking aneurysm. His was at 5.2 cm. I’m guessing his was part of the descending part of his aorta; as the surgeon stated he fixed the short part of the candy cane. Thank you so much for explaining this more in detail.
Sounds like he is doing well. Great to Hear!
@@cardiacsurgerypatienteduca2445 he’s doing very well for the risk and the 50/50 mortality rate he had coming out of it. It’s just dealing with the aFib now. He had surgery Thursday and should be coming home in a day or two.
Thanks Doc.... 63 y.o. ...Just clocked a 4.3 and thank God we like in the 3rd millennium!! June will get more details... Also I have a lot ... A LOT ... Of friend who got heart attacks while bench pressing .. ironically, I couldn't bench lately because of a pinched nerve in right shoulder...
Take care and thanks to all for giving me a little comfort for available options .. 😊
Very interesting program, with great explanations, thanks Doc.
Brilliantly explained. Sharp doctor. 🧠
Thank you for the kind comments.
Huh. My father in law just had a AAA repair yesterday, and this video is in my feed.
I just had a CT yesterday for a lung cancer screening and they discovered that I have an ascending aortic aneurysm that is 4.8 cm. I'll be receiving a referral for a cardiac specialist but I wanted to do a little googling to find out more and came across this video. Thank you for explaining it so clearly and concisely. You're quite good at this.
Thank you for the nice comments. Keep your blood pressure controlled and get a well experienced cardiac surgeon who specializes in aortic surgery to follow you. Hopefully with good blood pressure control, it doesn't grow. Good luck!
My ascending aorta aneurysm is 4.5cm. It was discovered pre-operation for bile duct cancer resection in July 2019.
Multiple CT scans for oncology treatment show no increase in size since original diagnosis.
I guess I'm lucky to be cancer free for 4.5 years as well as the aneurysm not enlarging! 😊
You definitely are fortunate. Congratulations on both. Take care!
Excellent description, doctor. My ascending aortic aneurysm is at 4.8 cm. It grew from 4.6 to 4.8 cm in one year and I'm 67 years old, in very good athletic shape. I'm going in for a CT scan on 4/3/23. Seven months ago my ascending aorta was at 4.8 cm. I am planning on an Atlantic passage with my sailboat, so this heart issue is definitely a problem. I just want to get the surgery over with as it has grown from 4.4 cm to 4.8 cm in less than two years.
Hi, I completely understand your concerns and the desire to get this taken care of ASAP. I have had patients who requested the surgery before 5.5cm however never before 5cm. I'll defer to you and your doctors. I strongly recommend that you select a cardiac surgeon who does this all the time. Good Luck!
@@cardiacsurgerypatienteduca2445 what is the normal rate of change? Mine went from 4 to 4.5 in 5 years (age 53 and now age 58). Is that slow, normal, or accelerated? This news is less than two old for me, I'm still a bit rocked by it.
Bravo Dr., Lemaire, you explained this very well, and much more thorough and informative 6 minutes than many others I watched prior to finding your tutorial. Guess I'm in the same boat and awaiting a surgeons consult after a recent CT scan. Thank you for providing this and answering so many questions from the audience. I had hoped this was not a major surgery but obviously it is not. Oh well, damn the torpedo's... after a second opinion of course.
Hi, I'm sure you will do well. I want to be clear if done by a surgeon who does this all the time, the surgical risk are low. Please get a second opinion but also get an experienced surgeon. I'm sure you will do well. Good Luck!
@Cardiac Surgery Patient Education Where are you located? And how much does a ultrasound or CT Scan cost, cash out of pocket, no insurance? For an Abdominal Aortic Aneurysm?
I’m having a procedure soon . Thank you
Good Luck!
thankyou you were so easy to understand
Thank You Dr Lemaire. I found your video fascinating and informative.
I've been advised that I have a small leakage in my A valve (not fully closing!) I'm reluctant to have surgery. Some years ago, I attended two bypass operations at different hospitals (on the same day) and actually held a heart in my hand during one procedure. It was the most amazing day of my life - thus far and excluding my wedding.... On both I was suited and booted.
I've been wondering if, with today's science and technology, we may be able to effect a repair without surgery. Probably not but a rotary saw opening up my chest seems archaic and invasive.
I guess for now I'll live with it.
Thank you again.
John Carroll (jayceemusic)
Hi John,
Thank you for your comments. If you were told, you have a small aortic valve leak, its' possible you may never have to have surgery. If you do require surgery there are multiple less invasive options to address your aortic valve issue. First, there are minimally invasive surgery (thoracotomy and not sternotomy). The incisions are smaller. Second, there are percutaneous options in development for the repair of the aortic valve or replacement but this will not be available for a few years. Finally, I understand why you are concerned about traditional surgery with your chest being opened, however the outcomes of these procedures are very good. Patients have been having open heart surgery for decades and the results in the correct hands are excellent. Good Luck!
Thankyou for this
I have a 5.5 cent aneurysm and currently waiting for an app to discuss when an op will be done.
Mine is thoracic
Also have an abdonimal one which is 3cm and are goong to monitor.
Your explanation was extremely informative and easy to undestand.
For that i thankyou so very much.
I appreciate your comments. I would definitely speak with a Cardiothoracic surgeon soon who is very experienced in this surgery. You meet the requirements for surgery right now. The success rate of the surgery electively is very high in comparison to if the aneurysm ruptures. Good Luck!
explain well done.
Hi Dr!
I want to congratulate you for the clear and helpful explanation for this condition. I my mom just had this surgery at some hours ago and there is some blood leakage coming out, it could be coming from the chest pressure from the process of wake up. She is still out. Is this abnormal?
When the graft gets put in, what will happen in the aspect of contractility function of the ascending aorta? Or is there enough pressure generated by contraction of the LV that it won't really affect BP if the graft part doesn't contract down?
Wow! Great tutorial, I want you for my 4.7cm TAA that was discovered during my knee surgery pre-op. Waiting for the next echocardiogram to see if it's progressing; hopefully not! Enough about me; you have a great speaking talent and articulation!
Thank you for the comments. I hope your aneurysm never grows and you don't require surgery. Keep your blood pressure well controlled. Make sure you have a cardiologist and heart surgeon seeing you at minimum annually. Take care.
THANKYOU!
@@cardiacsurgerypatienteduca2445
how much will losing weight help to prevent growth from from occurring and/or worsening the situation? I noted that you mentioned lowering HBP as well . I’m starting to take away meat from my diet as well
@@dwillmayne5516 Thanks for the question. Losing weight could contribute to lowering your blood pressure and that will improve the situation. The critical aspect is keeping your blood pressure controlled. Personally anything that will overall improve your health will improve the situation.
Fantastic and easy to follow presentation for the average patient such as myself. I am not a Marfan patient. My genetic connective issue is ehlers danlos. Thanks .
Thanks for the comments.
@@cardiacsurgerypatienteduca2445 Can a Stent Graft be installed into the ascending aorta instead of the above surgical repair?
Dr Anthony, thank you for a very clear explanation for us laypersons. I’m 63, had CAC done in March of 2023 with a score of 4.76, however an asc aortic aneurysm was found that was 4.2cm. My cardiologist did not say anything to me! And I happen to be going through my report from 2023 a couple of weeks ago when I found the AAA result!!!
I have been on keto diet for about one year and I decided to get another CAC which I had two weeks ago. My CAC score is now 15 but the AAA is 4.1cm. 0.1cm smaller that last year.
I don’t have insurance and tight on finances, so I want to ask you if I should worry about my AAA at 4.1cm?
I’d really appreciate your feedback!!!!!
Thank you very much!!!
I appreciate the question. I would state that an ascending aortic aneurysm of 4.1 or 4.2cm will most likely not grow to the 5.5cm however, it still needs to be monitored. By the way, aneurysms don't get smaller so the 4.1cm that was just pointed out is most likely a variable based on the person reading the CT scan. Radiologists can measure the same CT scan differently. Either way continue to monitor. Keep your blood pressure controlled.
Our daughter has Turner’s syndrome and has a bicuspid aortic valve. Her aorta was perfect until we put her on Norditropin (growth hormone) and it was discovered after a year that she had a mild aneurysm. It was written off that it had anything to do with the GH. We continued using them. At her echocardiogram a year later they said it went from mild to moderate. Still rejected the idea that Norditropin had anything to do with it and they highly recommended continuing using it. Finally, due to a global shortage we opted to quit using it and at her last echo it was recommended that she have a sedated cardiac MRI because her aorta looked different. I am confident there is a correlation, as now her Z-score is 5.29 and the aneurysm is classified as “severe”, per the radiologist’s analysis. Our cardiologist has yet to return our calls or schedule anything, even to review the results. To go from mild to severe in a pediatric patient with normal BP seems frightening and that surgical repair is imminent. How would you recommend we proceed?
I should add that she is just 8.5 years old.
Hello Dr, I had a heart operation in February and they left the top of my sternum open, I am now having a quiver going down the center of my chest and a pain that comes and goes in my right hip joint, at my aorta. What can I do. The doctor says there's nothing wrong with my heart
Thank you Doctor you explained everything well! My brother has an enlarged aorta and may have to have surgery! I'm scared for him! He has Central sleep Apnea really bad and sleep paralysis also. He has Diabetes which is severe and he's considered a High Risk patient! I'm scared for him.
Hi, please make sure your brother sees an experienced surgeon. Those are important risk factors but an experienced surgeon should get him through it. Good Luck!
Best explanation I’ve heard. Clear anatomical description and function of the heart & aorta. Easy to visualize and understand. Realistic. Thank you Dr so much! What is your name?
Thank you for the kind words.
I'm interested about the gortex graft. When you sew it in and it is in position will there will a weakness at the 'sewing line'? I will probably be needing this surgery at some point. Also, after the op do you still get screened to ensure everything stays in place? How common is it that the anuerysm develops again even with a graft? Thank you for your very helpful video.
Hi, I wanted to clarify that there are different types of grafts and actually the most common type of graft is the Gelweave graft not Gortex which I mentioned. Anyhow, you are correct that the "anastomosis" is the most important part of the connection. I don't want to use the word "weakness". Second, the aorta that is left behind can grow to become an aneurysm but what you remove obviously is gone. The patient's do require observation or surveillance after surgery to make sure that the remaining aorta doesn't grow. Its hard to say how common it is that the re
maining aorta becomes an aneurysm. I haven't seen the studies but I don't expect it to be high.
@@cardiacsurgerypatienteduca2445 Thank you so much for your very fast and clear response. Much appreciated.
I have one, it was found 2 years ago when I had a massive heart attack, they had to put a stent in my RCA and found it then, it was 3.9, have not had it checked since, but I do have an upcoming appt to do just that.. Never have any pain... My mom had one too, almost the same size and hers never grew past 3.9 and she lived to be 83 years old and died from sepsis..
Hi, sorry for the delay in responding. I'm glad that your mom's aneurysm never grew more than 3.9cm. I would strongly recommend that you keep your blood pressure controlled, follow with a Cardiothoracic surgeon, and a cardiologist. Good Luck!
Can I have weight loss surgery if I have a mildly descended aorta?
The aortic root is grossly normal in size at the sinuses of Valsalva. The ascending aorta is mildly dilated. Ascending aorta measures 4.1 cm@ 3.1 cm distal to STJ.
This was an echocardiogram.
But they also said that it was hard to interpret because of my weight. My BMI is 64.
So do you think elective surgery would be safe? I'm a 56 year old woman. I have also had a heart ablation 2 years ago.
Hi, Sorry for the delay in responding. At 4.1cm, you should be able to have weight loss surgery. The risk of rupture at 4.1m although not zero is relatively low. I would personally communicate your concerns with your abdominal surgeon and anesthesiologist. Personally, I think you will benefit from the weight loss surgery given your BMI. Good Luck.
Very good explanation I actually have aortic ascending aneurism very big ! But I was told that it would be risky to be operated I could be paralyse ! So I decided to reject any operation and see what will happen ! So far I am ok but not perfect ! I believe that only GOD can save me !
yes i like what you said.....
Hello, About 4 months ago I was informed by a Cardiac surgeon that my ascending aorta was 4.4 cm and not in need of surgery until 5.0 cm. I also require surgery for mitral valve prolapse. Do you recommend aorta surgery @ 4.4 cm concomitant with MVP surgery? Can the comorbidity surgery be done robotically? I am 70 years old w/ high blood pressure and mild shortness of breach but workout 3 days a week. Will most surgeons allow this type of surgery? Surgery will be done at Scripps Hospital in San Diego in a couple of months.
Hi, Sorry for the delay in responding. I'll address your questions, one at a time. First, at 70yo, it's probably unlikely that your aneurysm will get to the 5.5cm indicator for repair. I think you need to clarify with your surgeon what size indicator he/she is using for surgery. You mentioned 5.0cm, is that because you have a bicuspid aortic valve? The size indicator is normally 5.5cm unless there are other issues. 2. If you have a bicuspid aortic valve and are having open surgery (sternotomy) then it's possible that the aorta can be repaired at the same time as the mitral valve. There are more issues that can be discussed than I can say on a YT channel. Please either contact me directly through my website or office to discuss. 2. The mitral valve can be repaired robotically but not the aneurysm. 3. You asked if "most surgeons will allow" this surgery. I'm not sure I understand what you mean? Allow what? Perform the mitral surgery and leave the aneurysm. Please clarify. I personally think the indication for repairing the aneurysm at 4.4cm depends on several factors. If you are getting a minimally invasive mitral valve repair, most surgeons wouldn't repair the aneurysm at 4.4cm but if you have a bicuspid aortic valve then the criteria to repair the aneurysm is 4.5cm so some surgeons would repair it. There are more to say but contact me if you want to discuss further.
hello dr. thank u for ur very nice presentation. I'm 56 yrs, was actively working as an RN, I had an emergency life saving aortic valve repair(bovine)post a type B dissection all the way till the rt. femoral artery 1 yr ago. Unfortunately had uncontrolled HTN that I didn't take seriously.
Please my questions are:
1- how long would a bovine valve live?
2- what's my life expectancy?
3- will I need to fear needing a kidney transplant in the future , have some microalbuminuria?
Hi, Sorry for the delay in responding. To address your questions. 1. A bovine valve will usually need to replaced in 10-15 years. 2. In general, if you are compliant with your medications and following up with your doctors, you should have a normal life expectancy. Of course, as you know, its not as easy as most people think to be compliant. 3. I wouldn't worry about the need for a kidney transplant, I would be focused on keeping your blood pressure controlled.
Can a Stent Graft be installed into the ascending aorta instead of the above surgical repair?
Hi, Currently Stent grafts are not available to repair ascending aortic aneurysms. One of the main issues is creating a graft that will not occlude the coronary arteries. There are several companies working on it and so I believe in the future there will be an option to treat ascending aortic aneurysms with stent grafts.
Last year I was found to have an ascending aorta aneurysm of 4.5 cm and bicuspid aortic valve. Cardiologist did not seem concerned. Yet by what you are saying I am at high risk for rupture ~ I will be seeing a new cardiologist in July and get a second opinion. Thank you for your informational video. One question: " Is there a risk to fly long distance with this condition?"
I sincerely apologize for the delay in responding. First, there is no issue or risk with flying with an aneurysm. Second, to address your question. As long as your bicuspid valve is functioning well, I would not electively replace your aortic valve or aneurysm. If your aortic valve however was not working well, which most likely would be aortic valve stenosis, then if you had surgery, the treatment would be an aortic valve replacement and aneurysm repair. I apologize for not being more clear but you wouldn't replace the bicuspid valve if its working. I also wouldn't just fix the aneurysm at 4.5cm. If the aneurysm does starting increasing in size, especially greater than 5cm, I would at a minimum see a heart surgeon. I would make sure that your aortic valve and aneurysm are being checked yearly with an echocardiogram and CT scan of the chest.
Hi doctor! Thank you so much for your informative video, I am 24 years old and got diagnosed with 4.5 aortic root aneurysm, I have a bicuspid aortic valve with mild regurgitation. The diagnosis was made just by an echo. My doctor said that their is no need to do a CT scan or mri. Also, they want to monitor me just by echo. Is CT scan or mri essential in my case?
Thank you in advance! Regards
Sorry for the delay in responding. I personally believe that a CT scan of the chest is important to serve as a baseline for your aorta. I would personally continue getting an annual CT scan of the chest and echo. The ECHO is to look at the aortic root, and aortic valve. The CT scan of the chest is to look at the ascending aorta, and remaining aorta.
Dr. Anthony, can't this surgery be done Endovascularly? Just like how it is done with the abdominal aorta?
Great question. Currently, ascending aortic aneurysms cannot be repaired endoscopically because of several reasons. First, because of the presence of the coronary arteries there has always been a fear that the grafts with occlude or block the coronary arteries. If that occurs that can be fatal as the heart would not get blood. Second, there has not been grafts created for the ascending aorta that have been FDA approved. Now, there are some off label grafts that can be used but to my knowledge, nothing has been approved. I suspect in the future there will be grafts for the ascending aorta but currently none there are commercially approved exists.
Thank you Dr. Lemire. I just found out that I have a 4.5cm ascending Aortic Aneurysm. My brother and sister (in Asia ) also have ascending and descending. I believed this is part our family's gift. Now , I am wondering what kind of Dr. I should look for to monitor my aneurysm in New York. I am 74, live in Nassau Long Island NY. I try not to have surgery, just like my brother he still hanging around there. I need to know how to avoid make it worse, so I can live longer. I appreciate that anyone can share this kind of experience.
Good luck. Keep your blood pressure well controlled and hopefully you could avoid surgery.
I have a question, for so long I've been having issues with numbness in my feet. Pain in my legs. Numbness in my face passing out very irregular, heartbeat and sweating When that happens. I found a chart that was from a doctor that I saw back in 2017, they did an EKG and found that it was abnormal. Then they did an ultrasound of my heart and evidently it found that I had atrial septal aneurysm! Nothing was ever said to me about this. I never saw the doctor again because when I went to schedule an appointment they were no longer there. I was made aware of this at a neurology appointment because the numbness in my feet is so annoying. They mentioned if I was aware that I had that show up on an echocardiogram. And I said no. I had no idea. I seem to have a really hard time finding a good doctor, I don't go to the doctor very often because of that reason. Is starting to be very concerning to me because I'm not sure if that is something that I have to be concerned about, but given my symptoms that I've had and do have from time to time, I'm wondering if that is something serious and how in the world did that happen? I would appreciate any input that you have. Thank you
Hi, sorry for the delay in responding. I think you need to sit down with a good medical doctor, and cardiac surgeon. There are many reasons for numbness in your feet and I don't think its related to the atrial septal aneurysm. Please contact me through my website and I can help refer you to a good cardiac surgeon in your area.
My brother had a 5.1cm aortic aneurysm at the root area that dissected and he died. Since there is some family history of this, I had been found to have a 4.6cm aneurysm at the root area and they suggested I get it fixed. Always wondered if we jumped the gun there, but it is done. Being an active person, ever since operation I get an uneasy pain or pressure in the chest and back when my heart rate peaks during exercise, this always happens. Stress tests, etc, have been ok. Ever hear of this effect? When hiking with friends I seem to be last one up hill, am 62. I always wonder if this is just some residual pain due to clamshell effect of having chest opened.
Sorry for the delay in responding. I personally think that operating at 4.6cm is a little early however since your brother died, I can understand why it was recommended that you have surgery earlier than the actual size indication (5.5cm). Regarding the chest pain you're having a lot depends on how long ago was your operation. If its been many years since your surgery, I would be more concerned. Although you had a stress test, sometimes those are wrong (false negative). A cardiac catherization to look at your coronary arteries is the best test. I would speak to your cardiologist about this. I would also go back to your cardiac surgeon to discuss. Good Luck.
How long was your recovery?
@@jamesreeves9740 I had the operation in May of 2013 and by October of that year I was hiking in Yellowstone. Took some time though to get back up to speed on activities.
Thank you for your explanation. My brother is going to have op in November. His AAA is in his tummy.😢
Hi, the surgery for a AAA in the abdomen is significantly less risky especially if it can be done with an endovascular stent. Good Luck
Does it have any cure without surgery?
What vitamin or mineral is good to strenght the aort vessel?
Sorry for the delay in responding. There is no medical cure for an aneurysm. You can treat these medically with blood pressure control but the ultimate treatment is surgical if it gets to the target size. You can always decide to not operate which has its own consequences but this would require a long discussion with the heart surgeon.
This week I was diagnosed with an ascending aorta aneurysm, 4.2. I am curious if anyone has had this type of aneurysm repaired using a minimally invasive procedure?
Hi, I apologize for the delay in responding. There are certain surgeons that can perform this operation through a minimally invasive approach. Hopefully you will never need the operation. At 4.2 cm that is a small aneurysm . I would strongly recommend keeping your blood pressure controlled, and get a referral to a cardiac surgeon. Good Luck!
Please can you tell me if my husband who has a 5cm asending aneurysm just found out, moderate aortic stenosis and bicuspid valve can be operated on? History of submarachroid hemorage small TIA and severe c.o.p d , its not looking hopeful 😢
Hi, I appreciate the question. First, as of right now, your husband does not have an indication to have surgery now. His 5cm aneurysm doesn't meet the 5.5cm aneurysm. His moderate aortic stenosis does not meet criteria for surgery. Now, his bicuspid aortic valve does put him at a higher risk of the aneurysm growing and potentially an aortic dissection. I would STRONGLY recommend that your husband gets seen by a very experienced cardiac surgeon. The subarachnoid hemorrhage puts him at a higher risk for intracranial bleed but if there is enough time between the diagnosis and surgery, the risks goes down. The severe COPD is another concern for possibly not extubating after surgery. Your husband needs several consultants (Neurologists, Pulmonologist, cardiac surgeon) to optimize his condition and make him a better candidate for surgery. I would not give up on your husband. Finally, I would ask your husband to please speak to his doctor and get the consults that you need. Please contact me directly through my website for referrals for experienced cardiac surgeons in your area.
Hi. Thanks for the video. İ have a bicuspid aortic valve and 4.85 aorta. Can it be by minimal invasiv procedure?
Sorry for the delay in responding. Yes, this surgery can be done minimally invasively. Please look into doctors in your area that can do that. You may have to go to a center that is a little farther from where you live. Take care.
Hello, I have a dilatation of my aortic root at 4.1 and I also have right bundle branch block. My question is whenever this goes to surgery, will the RBB be a deciding factor of mortality with open heart surgery to fix the aneurysm? Thanks
I apologize for the delay in responding. First, depending on your age, there is a chance that you may not require surgery. However, the presence of a Right Bundle Branch block is not a deciding factor in having surgery. The 3 critical factors are (1) Size of the aortic root, (2) Presence of aortic valve regurgitation, and (3) the presence of symptoms.
Thank for this well informative video. I am at 4.4x 4.5 and I cough all the time. The cough is so bad it wears me out. I have seen every doctor ENT, Lung, allergist. Will Ascending Aortic Aneurysm cause a cough?
I'm sorry your dealing with the cough. Its unusual for an aneurysm to cause a cough unless it was extremely large and perhaps irritating surrounding structures. The size of your aneurysm doesn't seem that big. If you really believe its the aneurysm then get a CT scan chest with contrast and have the radiologist determine if the aneurysm is compressing any structures. Good luck!
Thanks so kindly for the explanation. Wondering if you perform EVAR for a diameter of 4.9cm on 78 years in an excellent shape? Thank you for your response.
Hi, Sorry for the delay in responding. I am a cardiothoracic surgeon and I do not perform EVAR for abdominal aortic aneurysms. I do perform TEVAR on Thoracic aortic aneurysms. I am not as familiar with abdominal aortic aneurysms but I believe the size criteria is 5.5cm for aneurysm repair. PLEASE confirm this with a. vascular surgeon. Good Luck!
Thank you so much appreciate your time
I am more relaxed now as I will meet with my cardiologist today.. I don’t want to give up my 2000 yard swim on almost daily basis I used Afrin spray and Sudafed pills for nearly 40 years that contributed in raising up my blood pressure..I believe it affected my high pressure negatively. I hope it’s not too late as I stopped cold turkey..Thank you again.
Thank you for this, I just learned yesterday I have a 4.5cm ascending aortic aneurysm. My daughter has Ehler Danlos syndrome so my doc is sending me for genetic testing to decide what's next. I'm fit as any 58 year you'll find, I'm ranked #1 in the world in the Spartan DekaFit Mile 55-59 age group, so this rocked me and I'm trying to learn as much as possible as fast as possible, I've done everything right in life when it comes to health, I can't believe this.
Does having Ehler Danlos change the equation that much? And if I can try not to "strain" too much, is it risky to compete in hybrid sports like Hyrox and DekaFit (kind of like crossfit with 8 1000m sprints between workout stations)?
Hi, sorry for the delay in responding. If you have any connective tissue disorder you generally will have an aorta that grows faster than someone who doesn't have that disorder like Ehler Danlos syndrome. I would say from a patient perspective I would (1) confirm the diagnosis, (2) keep your blood pressure well controlled, and (3) get referred to a cardiac surgeon (experienced in aortic surgery). I would say that it's ok to work out but as you stated, I would try to limit activities with lots of straining such as power weight lifting. Your aorta is relatively small at 4.5cm and you have no indication for surgery at this time. There is a good chance that you will never have to have aortic surgery.
@@cardiacsurgerypatienteduca2445 I wish I could do something to show you my gratitude, your reply is the best news I've heard and gives me hope....thank you so much...the world needs more people like you....thank you again.
I am 48 f I have a 3.5 cm distal? AAA. The aneurysm was found in Feb 2022 and I have my next ultra sound in April. Is it true that AAA are more aggressive in women and I have a higher chance of rupture at a smaller size and dying?
Hi, I apologize for the delay in responding. I'm not certain I know where your AAA is. If you are referring to the ascending aorta then a 3.5cm is relatively very small. As I mentioned in the video the indication to operate is 5.5cm so you are very far away. Similarly, if you are referring to an abdominal aortic aneurysm, it's still considered very small. To answer your question, I do not believe aneurysms are more aggressive in women. The size criteria for women is the same but I suspect that since most women are smaller than man, that an aneurysm may rupture at an earlier size relative to the smaller women's size. For example, a 4.8cm aneurysm in a 5ft size woman would be more likely to rupture than in a 6ft man. Ultimately, I think women may rupture at a smaller size but it doesn't happen all the time. I strongly suggest that you find a surgeon that you trust and get close follow up.
Im 70 years old, had a life of sport (bicycle racing, with at some point a vo2max of 73), nor mal blood pressure now, 79 kgs and 1.82, no cholesterol problems. But chest pain and shortness of breath while cycling and walking at a brisk pace.
A lung ct scan revealed and ascending aorta of 4.7 cms.
What to do. I feel im too young to just give up on all sport activities, especially the bicycle.
Id be grateful for any advice!
Hi, sorry for the delay in responding. An aneurysm of 4.7cm is most likely NOT causing you to have chest pain and SOB. Aneurysms classically only cause symptoms AFTER they rupture. At 4.7cm, you do NOT meet criteria for surgical intervention. I would STRONGLY recommend talking to your cardiologist to work up the TRUE cause of your symptoms. I would find the true cause of your symptoms before aggressive exercise. Once again, without more information, I see no reason for surgery.
@@cardiacsurgerypatienteduca2445 thanks very much, don't worry about delay. I don't expect instant response! 😏 I've been to the cardiologist a few days ago, he suggested going to better specialist in Bangkok (I'm in Hua Hin, a smaller town).
I don't know about that. Might do that later. In the meantime I'll take up cycling again, see if that will improve the condition. And I'm doing it gently. I'm not going to it like I did in the early 80s. All those years of training and racing have taught me to recognize how my body reacts. Heart and lungs are not the same as legs ...
I record my modest activity on Strava: Freek Faro.
Wonderful video sir. Thank you.
I was having chest pain after only swimming 2 laps but I could do 6 miles on the treadmill, and go skiing at 12,000 feet, with no problems. Saw a cardiologist and was measued at 4.4cm in Oct, with a tricuspid valve. I have no other issues with my heart, low risk factor for lifestyle and no family history. Doc put me on Lisinopril and I just had another echo and it showed only 4.1cm this time, and the technician spent 40 minutes looking at it closely.
Question: is it possible that the medicine reduced my BP such that the aneurysm shrunk or do you suspect the 1st measurement of 4.4cm was just a little off?
Thanks.
Great question. In my opinion, the aorta does NOT decrease in size. You have to make sure that you are comparing the size of the aorta with the same studies. A CT scan of the chest with contrast is the best test to measure the size of the aorta. An echocardiogram is good but not the best test. I suspect the 4.4cm size wasn't accurate however, what was the test that measured the 4.4cm? If it was a CT scan of the chest then perhaps the 4.4cm was a technical error by the radiologist. There are so many possible issues, the bottom line is the CT scan of the chest is the best and compare the size of the aorta with the same studies.
@@cardiacsurgerypatienteduca2445 Thank you for your reply. Both tests, 1 done in early October and the 2nd done last week, were done with an Echocardiogram. My doc ordered a PET Stress Test but insurance denied it and approved a Nuclear Stress Test as a sunstitiute. Also had that last week and have appt today to review findings. My carotids have some plaque but doc said not enough to have to have procedure to clean it out. Wondering if obstruction in Carotids can cause the aneurysm in the acsending aorta?
I was recently told i have a dilatation of the ascending aorta. 2.9 cm
I also have hypertension, high pressures on the left aide of the heart. Do i qualify for the surgery now?
Thank you for the question. The answer is no. The standard clinical size for surgery is when the ascending aorta is 5.5cm. There are some exceptions. Please review the video. Thanks
Hello Doctor,
My family member was just told his abdominal aorta aneurysm has grown to 7cm. They want to perform surgery, but he is extremely afraid, and thinks he can control it by controlling his blood pressure. I'm worried because I'm reading that surgery is the only option. He is 58 years old. What are his chances of survival in this scenario? Is the endovascular repair his best option?
Hi, at 7cm I would strongly recommending having the aneurysm repaired. The risk of rupture is very high. I would strongly recommend doing some research and finding a good vascular surgeon who could operate on him. There may be an endovascular repair option. I would try to get this done ASAP. If you want a particular referral contact me at www.cardiacsurgerypatienteducation.com.
Thank you for the very informative video.
Are they currently able to repair ascending aortic aneurysms non invasively? I think it’s called TEVAR?
Great question. There are currently no FDA approved stents that can treat ascending aortic aneurysms. TEVAR is available for aortic arch and descending aortic aneurysms but NOT currently for ascending aneurysms. The main reason is because there is concern that the stent would block off the coronary arteries.
Are people that workout and train hard at higher risk of rupture? My ascending aorta is at 4.6 cm and sometimes when I’m training I worry about it. It was discovered 4 years ago and initially was 4.5cm so it’s slowly getting bigger.
Hi, Good question, the short answer is that exercise could result in an increase in size of the aorta however, its' hard to say because there is not much research on it. I can say that exercise such as powerlifting can increase your blood pressure which could lead to aortic rupture. I don't know if there is a clear relationship between working out and increasing your aorta. I suspect that cardio work such as running, etc., wouldn't increase your aorta but I don't have definitive proof.
@@cardiacsurgerypatienteduca2445 thanks for taking the time to reply. I appreciate it.
Im 70 years old, had a life of sport (bicycle racing, with at some point a vo2max of 73), nor mal blood pressure now, 79 kgs and 1.82, no cholesterol problems. But chest pain and shortness of breath while cycling and walking at a brisk pace.
ECG shows a slight abnormality in the left ventricle. Angiogram shows a minor obstruction (20%) of some artery, otherwise it looked very healthy according to the doctor.
A lung ct scan revealed an ascending aorta of 4.7 cms. Could that be the cause of the chest pain and shortness of breath.
What to do. I feel im too young to just give up on all sport activities, especially the bicycle.
See above
@@cardiacsurgerypatienteduca2445 sorry about the double post. Some error on my part!
if calcification reaches the heart muscle through the ascending aorta whether heart muscles also get classified in long term?
Sorry for the delay in responding, calcification doesn't technically get into the muscle. Its most likely to get on the aorta or valves.
@@cardiacsurgerypatienteduca2445 thanks for the reply sir.
Hey Doc , I have a aneurysm of 4.6 at the amending aortic root. What is yhe most difficult to repair. Thanjs
Hi, There is no "difficult" time to repair however, the size indication for surgery is 5.5cm. Most surgeons don't wait that long though. I would strongly suggest that you meet with a cardiac surgeon to discuss this. There are multiple issues that need to be reviewed. When the aortic root is enlarged the aortic valve will often not work well. Good Luck. If you have additional questions, please email me.
Outstanding. I have BAV and ascending aortic aneyrysm. What state are you in?
He's in New Jersey