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Enlarger Aortic Root
when I was 15 I had been diagnosed with and enlarger aortic root with a diameter of 4 centimeters. the other day for my one year check when I am 16 my root had enlarged .2 centimeters and now is at 4.2 centimeters. I was wondering what is there that could be done. What are some treatments?...what can I do and what cant I do?....and am I going to need surgery?.. .
ARB therapy for thoracic aortic aneurysms is a cutting-edge intervention, and if I had a presurgical aneurysm, I would try it. Unfortunately, I did not find out about my aneurysm until it was already big enough that I needed surgery. Also, I had severe aortic regurgitation at the time, which was another indication for surgery.
But if one of my young relatives were to turn up with a similar aneurysm (God forbid), I would definitely encourage them to pursue high-dose ARBs. You need to control blood pressure anyway, so what's the harm in using the drug that shows promise of reducing the aneurysm? If you end up having to have surgery anyway, then that is the outcome that was expected in the first place.
But if one of my young relatives were to turn up with a similar aneurysm (God forbid), I would definitely encourage them to pursue high-dose ARBs. You need to control blood pressure anyway, so what's the harm in using the drug that shows promise of reducing the aneurysm? If you end up having to have surgery anyway, then that is the outcome that was expected in the first place.
QUOTE: does the aortic root always grow at a rate of .2 cm a year?... will the aortic root ever stop growing?.. and how is the surgery done?... thank you for giving me some answers..
>>>>Yes, there can be a differential on rate of growth A consideration for intervention is recommended when a small aortic aneurysm grows more than 0.5 cm within 6 months.
"Surgery to repair an aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place. This procedure requires open-abdominal or open-chest surgery, and it will take you several months to fully recover".
>>>nickppatel, is probably the most knowledgable on this forum based on the experience with the subject, and I respect his opinion as I have read and answered his prior posts, but if I remember correctly, there wasn't an answer to my questions several months ago regarding the basis and what method was followed in measuring the progress of his/her condition.
nickppatel provides a perspective, but I haven't found anything definitve other than reducing and maintaining low blood pressure. Often the underlying cause is a vessel tissue disorder exacerbated by high blood pressure and a lack of elasticity of the vessel and an ARB doesn't restore elasticity or change the composition of vessel cells.
>>>>Yes, there can be a differential on rate of growth A consideration for intervention is recommended when a small aortic aneurysm grows more than 0.5 cm within 6 months.
"Surgery to repair an aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place. This procedure requires open-abdominal or open-chest surgery, and it will take you several months to fully recover".
>>>nickppatel, is probably the most knowledgable on this forum based on the experience with the subject, and I respect his opinion as I have read and answered his prior posts, but if I remember correctly, there wasn't an answer to my questions several months ago regarding the basis and what method was followed in measuring the progress of his/her condition.
nickppatel provides a perspective, but I haven't found anything definitve other than reducing and maintaining low blood pressure. Often the underlying cause is a vessel tissue disorder exacerbated by high blood pressure and a lack of elasticity of the vessel and an ARB doesn't restore elasticity or change the composition of vessel cells.
my doctor had gotten back to me and said the growth of my aortic root (which is .2 cm in one year).. was not important because my body had grown with the aortic root.. so is there still a chance that it will still grow and that i am going to need surgery?
Actually, it is believed that losartan, an ARB, does work at the cellular level to inhibit and/or reverse the progression of aortic root aneurysms, at least in some cases. For one publication, see the article, "Recent Advances in Understanding Marfan Syndrome: Should We Now Treat Surgical Patients with Losartan" by Peter Matt et al in the Journal of Thoracic and Cardiovascular Surgery, 135:389-94. There is an abstract that can be accessed on the internet. Anyone who wants to know more can look up the work of Dr. Hal Dietz, who is prominent in this area of research.
As I say, this is cutting edge stuff. Clinical trials are still underway, but it looks like a very promising approach. And if you need to control blood pressure anyway, what's the downside to using an ARB, such as losartan? I can't see any downside. At worst, you are eventually going to have to do whatever it is that you were going to have to do if you didn't try the ARB therapy. The safety and efficacy of ARBs as a class of antihypertensive drugs is well established.
As I say, this is cutting edge stuff. Clinical trials are still underway, but it looks like a very promising approach. And if you need to control blood pressure anyway, what's the downside to using an ARB, such as losartan? I can't see any downside. At worst, you are eventually going to have to do whatever it is that you were going to have to do if you didn't try the ARB therapy. The safety and efficacy of ARBs as a class of antihypertensive drugs is well established.
Pat, I don't think you know yet how much it is going to grow. That's why the doctor is having you come back and be monitored from time to time. It's like trying to predict how tall you are going to be. You just don't know until it happens. Your aortic root is already bigger than normal, though, so you have to keep up with your check-ups. Maybe you, your parents, and your doctor will want to look into this ARB therapy and see if it might be a good thing for you to try.
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