aortic root

[GMP23]

I had surgery for an aortic arch aneurysm. In my followup a year later I was told that my aortic root was still enlarged and that it would need to still be monitored. Is that because my aortic valve did not need to be replaced or could their be some other reason?

[skydnsr]

There is a familial aortic aneyrysm disease that can affect people who have normal (three-leaflet) aortic valves.  It is sometimes called TAAD (Thoracic Aortic Aneurysm Disease).  Or maybe you do have a bicuspid aortic valve, and as nickppatel states, bicuspic aortic valves are often associated with root aneurysms.  You can find more information about both TAAD and bicuspid aortic syndrome at www.bicuspidfoundation.com.  

It is a possibility in my mind that your surgeon simply did not think you could withstand two procedures at one time, as it would have lengthened your operation.  Perhaps he operated on the problem that was more severe and left the other one for later.  Or maybe the root was only slightly enlarged, and he left it alone in the hope that it will remain stable and never need to be operated on.  Only he can tell you what his reasoning was, as he planned your operation.  

But as also noted by nickppatel, operating on the arch will not do anything to correct a root enlargement.  If the root was enlarged before your operation, then an arch repair alone would not have fixed any problem with the root.

[nickppatel]

Your question is not very clear.  You said that your aortic root is "still" enlarged, which indicates that it was enlarged to begin with.  Well, if that's the case, and you only had surgery on your aortic arch, then there's of course the aortic root is still enlarged.  Why would it shrink?

If the aortic root bulge is new, and if you're asking whether the aortic root is enlarging because of the surgeons left your aortic valve intact, well, then, the answer depends.  If you have a bicuspid valve, which makes people prone to aneurysms, I doubt the surgeons would have left it there.  So you probably have a tricuspid (tricuspid = normal) valve.  If that's the case, there's no reason of which I am aware that it would contribute to an enlarged aortic root.

More likely, in my layman's opinion, you have some sort of aortic pathology (connective tissue disease? Marfan? Ehlers-Danlos? Loeys-Dietz?) that affects multiple parts of your aorta.  You may be prone to developing aneurysms elsewhere besides the arch and the root.  

You really should click on my screen name and look at my recent posts about the ARB and ACEis drugs and related Johns Hopkins studies.  If your aortic root is not too big, you might be able to stop its progression or reverse the growth.

N