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Should I ask to have my aortic aneurysm repaired?
My name is Ekrem and I am 51 years old. I was just told that I have an aortic aneurysm which is 4.7cm and I was told that I am not surgical candidate until the size grows to 5.5 cm. I am not a smoker and never was, however, I do have high blood pressure where at times I can't control it. I am slightly obese (5'10'' 237 lbs). Should I be concerned about this and should I ask to get it repaired? Thank you so much.
submitted Ekrem from Utica, New York on 2/08/2013
by Texas Heart Institute cardiovascular surgeon, Joseph S. Coselli, MD
In answer to your question, although it is true that we generally wait for thoracic aortic aneurysms to grow to a size of 5.5cm there are some circumstances in which this is not the case. Some of these, but not all, include rate of growth faster than 0.5cm per year, a positive family history for similar aneurysms, a family history of aortic dissection or rupture, a genetic etiology such as Marfan syndrome, Ehlers-Danlos, Loeys-Dietz, etc., and a configuration of the aneurysm which is saccular. Chronic high blood pressure, particularly blood pressure that is poorly controlled and erratic, increases the risk of aortic problems at any size. If it involves the aortic root and there is concomitant coronary artery disease and/or aortic valvular leakage, etc., then 4.5cm is the cut-off. Certainly, at 5’10”, 237 lbs., regardless of what you do, loss of weight would absolutely be in your best interest. Although it does not sound as if you have an emergency, it would be important for a physician to actually review the studies you had which diagnosed the aneurysm (echocardiography, CT, MRI, etc) to have a better understanding of the location of the aneurysm and its anatomic configuration.
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Updated February 2013