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Author Topic: Why would one want an aortic aneurysm to grow to 5 centimeters before fixing it?  (Read 18008 times)

Offline Karen W.

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So I received no reason for this and I want to know why Doctors choose to let the Aneurysm grow to a larger size before shoring up the Aortic wall! I have an aneurysm in my ascending Aorta..It is 4.5 centimeters now, but I do not understand why we wait till it reaches 5 centimeters.. He says the wall has thinned but not as far as it will when it grows bigger, and when that happens he will shore it up. He says it could rupture but he feels it best to wait until it reaches 5 centimeters.. Why wait when he has to do it anyway.

Are there benefits to waiting?

I also have to have the aortic valve replaced along with the left ventricle.. I understand these may be addressed at the same time depending on what my condition will be at the time!

So please explain if you will some of the reasons for waiting.. could it be my other health issues?
« Last Edit: 27/01/2008 20:36:47 by Karen W. »


 

Offline opus

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I have heard that sometimes they stop growing and are therefore no longer worth the surgery. Indeed post-mortems commonly show up aneurisms in old people which are fairly large but were not the cause of death and were asymptomatic. So surgeons may be reluctant to carry out surgery on non-life threatening ones. This is the trouble with large sceening programs.
           But I am not in the medical profession and your doctor/surgeon is of course the best person to advise you. All the best.
 

Offline Karen W.

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It is going to be done when it reaches 5.. It is at 4.5 centimeters now! I don't know how fast it is growing so we have to keep an eye on it!  I just wondered why wait until it is so close to rupturing..?

Thanks for the opinions opus.
« Last Edit: 27/01/2008 20:38:47 by Karen W. »
 

Offline Carol-A

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I have no idea, but it sounds scarey to me. 5cms is pretty big. Perhaps he is afraid it would have to be done a second time if they do it now, and all heart surgery is a risk.
 

Offline Karen W.

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Yes it is Carol.. Makes me really nervous!

Well My understanding thus far is that when he goes in its not to remove it but rather

to insert a line or tube inside if the ascending Aorta which will basically reinforce

the walls in the ascending section where the Aneurysm has developed, Taking the pressure

off the thinned walls and preventing them from thinning any more as the blood pressure

rises etc. I know now that upon exercise that my heart becomes over stressed or the

blood pressure becomes to much and it pumps the blood through the aorta into the left

ventricle so it can be circulated throughout the body and to the other organs. Whats

happening is that the left ventricle has a problem and is being over loaded with more

blood then it can handle, so it pushes backwards because it can't move the amount of

blood normally moved thru, and it is pushed backwards through the aorta causing what he

called Aorta regurgitation. The blood then pools into the leaky Aortic Valve forming

blood clots and the blood pressure to build in that ascending Aorta and has caused an

aneurysm to form, which will continue to grow. In the mean time the blood clots are

traveling to the brain and lung so he has put me on stuff to thin the blood. He said he

could remove it any time between 4 and 7 but he wants to remove it at 5, but offers no

explanation as to why we wait... I am nervous and want him to fix it now, but am

frightened of that too.

I would just like to know some of the reasons they would wait and allow further

expansion of the aneurysm. Surely there must be other reasons that I am unaware of!
« Last Edit: 27/01/2008 20:40:20 by Karen W. »
 

Offline Karen W.

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Thanks for your responses Opus and Carol!
 

Offline Carol-A

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How are you now Karen? Any closer to having your op. and getting your problems properly sorted?
 

Offline Karen W.

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I go see the doctor on the 29th again.. Starting The antibiotics I hope.. The last few days have been tough .. My lungs are real sore coughing has become all day and all night thing and my lungs seem full of fluid.. but I can't seem to clear it!... I won't know till they go take a measure of the aneurysm and that won't be for a few months.. He said he will check it every couple months... it is going to get 1/2 centimeter bigger before he does anything.. Seem to be having more trouble breathing or standing for two long.. I am good about ten minutes if that on my feet before I get sick.. Then on comes the nausia, followed by dry heaves and then dry hacky cough then a croupy nasty cough.. sound like I have TB or am a bad smoker, and I have never smoked..coughing all the time..

I am a bit mad right now as they are taking so long with treatment... I have forgotten what well feels like! I hope I get to see it again.
 

Offline Cobra038

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Karen,
     Because prior to 5 cm, the risk from surgery is greater than the risk of the aneurysm rupturing. Sometimes they stop growing and you may not need surgery. There is risk to all surgery. Take sensible precautions in your daily life, continue your regular scans, and enjoy every day. Even the healthiest of us are not guaranteed any day beyond today. 
 

Offline Karen W.

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Thanks Cobra... yes I have to take precautions mainly my body has been taking them for me as it seems to have set its own limitations about slowing me down with shortness of breath.. chest pain unstable angina and nausea upon exertion.

The aneurysms are causing me discomfort... and I wish they would not wait.. I feel like they are playing Russian Roulette with my life!

I have two aneurysms now both have become about equal in size over the last year. I am set for another big Stanford visit around September 1rst.

They will be checking my liver kidneys and doing new scans to check the size again...i had one about two months ago...  scan was fine no changes really just small ones, but the liver and kidneys are still not working properly.

Thanks for your advice and I am doing the best I can... thank you so much!
 

Offline PaulMcKein

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Hi,this article about aneurysm treatment can be useful for you:
newbielink:http://aneurysm-signs.com/treatment [nonactive]
 

Offline Karen W.

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Thank uou Paul that was an informative link. As of March I attended my yearly check of both my ascending and descending anuerysms down at Standford...and My upper anuerysm came in smaller then last year which was 4.7 It went down most of a centimeter...I was shocked and glad! I did not know they could shrink! While there My cardiologist had to go over all my heart issues to give my Drs. here the green light for a lumpectomy/ mastectomy...depending on the spread of the cancer I was diagnosed with a bit over a month ago I believe....He approved surgery and radiation..and said that my aneurysms are stable for the time being so green light was given...
 

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