Doctor Q&A: The Progression and Surgery of Dilated Aortic Root Aneurysms with Dr. Luis Castro
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- Опубликовано: 13 июл 2022
- www.Heart-Valve-Surgery.com - Dilated aortas may cause life-threatening situations for patients if their aneurysm tears, dissects or ruptures. For this reason, patients are concerned about the progression of all aneurysm types along the aorta which is the largest blood vessel (artery) in the human body.
In this special video, Dr. Luis Castro answers an important question from Desmond, a patient from Dublin, Ireland, about the need for surgery specific to his dilated aorta which currently measures 4.5 centimeters. Doctor Luis Castro is a leading cardiac surgeon at Dignity Health Sequoia Heart Hospital in Redwood City, California near San Francisco. During his career, Dr. Castro has performed over 5,000 cardiac procedures for heart valve disease and aortic aneurysms.
Key questions addressed by Dr. Castro during this video include:
1. How do dilated aorta progress? What is the risk of a dilated aorta and aneurysm?
2. What role does a patient's age play specific to the progression of aortic root aneurysms and the need for surgery?
3. How do medical guidelines help surgeons make decisions about operating on an aortic aneurysm?
4. How does patient size impact the timing of an aortic aneurysm operation?
5. Why can aortic valve disease influence the progression of aortic root aneurysms?
6. What should patients do to monitor aortic aneurysms? MRI? Echocardiogram? Stress test?
To learn more or schedule a consult with Dr. Luis Castro, please call (650) 399-2035 or visit www.heart-valve-surgery.com/s....
i’m cooked. i have a dilated aortic root at 16. i also have bicuspid aortic valve
I am not sure if this is the correct forum to ask this question. I have had an aortic valve replacement. A 20mm Edwards valve. I'm not sure what model. I am due for a replacement and want to know whether a valve in valve is possible would the valve opening of the new valve be reduced radical
The study was technically limited.
• Heart Rhythm: sinus rhythm.
• Normal chamber sizes.
• The left ventricular global systolic function is normal. No left
ventricular segmental wall motion abnormalities identified, but
endocardial definition is suboptimal.
• Valves poorly visualized, by color/ Doppler, no obvious significant
abnormalitites
• 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
• The inferior vena cava is not well visualized, probably at least mildly
dilated
• Compared with prior report dated 1/28/2022: ascending aorta was not
visualized on prior study
I am a 56 year old woman with a bmi that is 66.
Do you think it would be safe to have weight loss surgery?
I have a 4.6cm im womdering how Desmond is doing now and what treatment he went through.
How old and how tall are you?
What happens when an ascending Aorta has dilation & the person has also AFib recently diagnosed? Can the ascending Aorta be causing one's AFib? thanks for the info & video, Aidan xx
That describes myself.
@@edwardenglish1519 They now found something else thinking it may not be Afib, they mentioned (PND) Paroxysmal Nocturia Dyspnea/Orthopenia/Dyspnea issues with oxygen/mucus, some say it indicates heart failure
I have had open heart surgery in the middle of lockdown at the Royal Papworth Hospital in Cambridge in the uk 🇬🇧 I had to have my aortic root cutaway and replaced i’m really like to exercise, but don’t know what I can do that won’t affect my heart condition?
Walking cycling and swimming
contact your local Cardiac Rehab department :)
If I have an aortic root at the base coming from the aorta is 5.1 when do I consider surgery?
They normally say at 5.5mm or if it grows more than 3mm in a year.
I’m 39 with a dilated aortic root of 4.2cm at the maximal transverse diameter via cta, with a overall growth of about 2mm over the past 7-8 years. Each diagnostic conclusion mentions no aneurysm, only dilation. I thought the two were interchangeable? My cardio still does biannual surveillance and have never been told aneurysm, only dilation. I’m 6’3” and am scheduled for cta in a few weeks
Do you have any connective tissue illnesses like EDS or Marfan's?
@@MRAIDANGWALSHnot that I’m aware of. I’ve mentioned this to cardiologist and he doesn’t seem to think. I did do an ancestry DNA heritage testing a few years back which was negative for fb1 genes and ehlers danlos. Who knows. It’s very frustrating never getting even a hint as to why or what I can expect in the years to come
Aneurysm is technical 150% of normal diameter, and they are often not mentioned (even at 4.6 cm mine was still 'dilated'), possibly for fear of frightening the patient. But basically anything above 4 cm is an aneurysm.
By the way, get seen by a proper aortic centre. A straightforward Cardiologist will follow the Guidelines but these are always behind the latest understanding that real aortic specialists have.
@@cliffg4437 I saw your other post that yours dissected at 4.6. Were you already aware of its size and were you being treated with meds? BB, ARBs prior to its dissection?
My Aorta diolation is currently 5.3 I am having more scans soon. Here in UK. I know I am facing surgery
Is it at your root? And did it take a while to grow mine is 3.5 I see the heart doctor again March 8 🥹
Mines 5.6cm. Found out very recently. Whats your experience like in the UK?
@Russia Bro Z (You know, like Dragonball Z lol) I'm 38.
I will refuse surgery.
Its my belief that the heart adapts to stresses like any muscle in the body. I used to be 126kgs bw... very muscular with LVH and diastolic dysfunction,
A recent mri says that has drastically reversed but the Aorta is now dialated,
Potential causes for it were (Stress+ covid + lifting too heavy natural). With just a few lifestyle and perception changes I already feel far better and can Skate, Jog and much more without any issues.
My current bw is 96kgs.
In my opinion and don't adopt it as your own,
surgery if you don't have Marfan is pointless and dangerous.
Modern medicine seems to be completely convinced that the body cannot heal or adapt at all in any way without being cut up or dosed up.
Maybe I'm a dumb ass and will drop dead suddenly some day soon.
But strangely my instincts tell me nope.
Just don't let this stress you out, negative thinking is of 0 use to you... and anxiety can go fk itself.
Remove the causes and the problem will be resolved.
If your an athlete like myself/I was, your aorta will be larger than sedentary peoples anyway.
More powerful engines require larger injectors and exhaust systems. Harvard have some great papers on this, that most cardiologists wont even be aware of for 10+ years.
Diagnosed with mine last year, I think the covid spike protein has everything to do with it. I also think building collagen, atp by adding copper, boron, silica, and getting rid of the dang spike protein will help.
@@whatsthatnow7466 interesting that you said this. How did you feel after getting covid?. Any vertigo or lethargy
Are there any studies regarding statistical values of growth per year for an aortic root?
General statistics don't count, what matters is what *your* aorta is doing.
Hi Dr Castro my name is Roger Brandon. My height is 58 I weigh 197. I’ve had a enlarged aortic route for many years. It’s been at 4.2 to 4.6 now the day I found out that it is 5.1 at the aorta group coming from the aorta how serious is that and when do I consider surgery?
5/8 my rate is 197 I am 66 years old
Hi Roger, Dr. Castro does not actively monitor the HeartValveSurgery.com RUclips Channel. That said, we would strongly encourage to discuss this issue with your cardiologist at your earliest convenience. You can learn more about guidelines for aorta treatment at www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/11/01/12/21/2022-guideline-on-aortic-disease-2-gl-ad. We hope that helps!
Mines 56mm/5.6cm at the root. Feeling fine but anxious since the news. Acquired via a random MRI. Age 37 5.11" height 205lbs muscular. Living in Ireland so Surgery or similar can just that get kicked down the road.
Mine is 4.8cm at the root. I'm 36 and very active myself and in good shape. Not sure how I got it since I don't smoke, rarely ever drink and never taken drugs in my life, but just as you are I am also very anxious and anxiety is off the roof. Hope your surgery comes successful my friend. My name is Elliot and im from the US
@@ElijahForPresident2034 I'm not getting surgery. Huge risk for potentially no gain. I'm fine with the 5.6cm if its even still at that size. Ireland is so slow and backwards that its DIY or die here, I had a flu during my MRI which may have contributed to the readings, it was very hard to hold my breath over and over during the MRI. perhaps I'm an idiot but I believe the heart responds and heals just like any other part if the body. I never smoked, don't drink, never used drugs and I eat healthy. Athletes have larger Aortas recent studies are starting to discover.
years ago when I had LVH I was told the same hypochondriac crap from specialists my LV wall was 19.7mm at the time... 3years later my hearth had responded to my lifestyle and was 14.3mm. I had lost 70lbs of muscle+fat. My research suggests Don't lift to heavy, keep stress minimal by focussing on achieving goals and pursuing knowledge, keep diet clean and nutritious, have a positive perception and your heart will adapt. I'm training light, easy l.i.s.s cardio, but I'm stressed out of my mind due to the dicks incharge of this country ruining the place but otherwise no pain no limitations... nothing. When I had LVH it was much worse, edema in the legs brain fog, chest pains etc, this is going to sound insane but men we have a certain organ that swells up in response to certain external factors yet said organ also contracts/shrinks right back down afterwards the Aorta made up of similar elastic tissues , if you have Marfan syndrome its a very different story but my belief is what can be done can be undone.
I was advised to get surgery on my back age 25 when I got a compressed vertebrae... I didn't listen and just began training... good mornings, light deadlifts to build the supporting muscles of the spine etc I'm 38 now and I skateboard and rollerblade, weight train and much more and I don't mean just rolling around I mean flips down steps, grinding ledges etc, serendipitously for my perspective I met a lady in a wheelchair at a market about a year ago...we got chatting and the subject of how she had a sky diving accident resulting in a compressed vertabre arose, she said she could walk and function with it at the time but her nerves would hurt from time to time, then she took the advice and got the surgery, the compressed vertabre was removed and the above and below vertabre fused together via pins/plates, 3 follow up surgeries later due to complications and she has been in a wheel chair since. Bottom line is... Learn from the lessons of others. Anxiety is a bitch, I've had girly moments/anxiety since my childhood... gratitude and creativity seem to decrease anxiety to the greatest extent. Pick 3 things each day that your grateful for and write or say them out loud. + Being creative alters brain chemistry and lowers cortisol. Painting, writing, creating businesses, planting forests, designing products etc create a purpose, outlet and a sense of accomplishment and at no time can your mind wander to negatives because its too busy achieving. Take the advice of your doctors but also listen to your body and intuition. Medicine/medical care is a business just like auto mechanic's or animal agriculture but instead of cars and cattle we are the valuable commodity. Its easy for a personal trainer to sell you a program if he convinces you that your a fat fk as it is for a specialist.... if you get my drift. Relax though I'm a good few months into this and its honestly sweet fk all. I bet you've no occlusion in your aortic root? (Should say on your mri results)
Did you follow up since?
Well, best of luck! I was all the things you describe, and not Marfans etc. I dissected at 4.6 cm. I wish I had even had the offer of preventive surgery. The dissection was completely life changing. I wouldn't wish my experiemce on anyone. The 5.5 or 5.0 cm diameter is entirely statistical, there is no proper science behind it, and there are plenty of outliers. A friend of mine dissected young and his life was saved at the Mater hospital i Ireland, so it's not true that everywhere there is behind the curve. Find someone who knows what they are talking about, at a major aortic centre. Elective surgery is ALWAYS better than emergency surgery.
My aortic dilation is 4.3cm the hospital said im okay that everything is stable but i recently started getting upper back pain , should i go get tbag checked out by the way im 5,8 slim guy . I also had a vsd repair when I was child if that counts for anything
yes absolutely. how are you doing now? Did you get it checked?
IS the radiation risks of a CT scan worth rechecking a 2yr old 4.1 aortic root? Or is it safe to wait a few more years before exposing myself to another CT scan due to the ionizing radiation they emit that damages DNA?
Ask for other safer method scans instead
CT scans are getting safer all the time. The question is, is the risk of not having the scan greater. I dissected at 4.6 cm and am now monitored annually by CT after my surgery. I never give the radiation a thought. YMMV.
@@cliffg4437hit ripped at 4.6? Gee what surgery you got
Hi from Saskatchewan canada how serious is a Aortic aneurysm I was diagnosed yesterday the surgery scared me
No worry at all
How old are you? And what’s the size of your aorta now. If it’s under 5. Yo will not need a surgery for a few years. If it’s over 5:5 then you’d doctor will advise to go a surgery.
It’s 99.8% successful. And sometimes they will do something like a stent. It’s ok.
HI Donna. I am a fellow Saskatchewanian. Have you had your surgery yet? If not I can answer any questions you may have about having the surgery in our province. The time before surgery is very scary but if recommended it will be necessary. Mine wasn't even found until it was 6.3 cm dilated so my surgery was fast tracked. They did my valve too. I'm told that I'm pretty lucky to still be here. I was back playing golf about 13 weeks after surgery.
I am a 17 year old with a dilated ascending aorta, and wanted to know if I'm able to go to the gym, because I am desperate to build muscle and get big.
What size ? My doctor never gave me any restrictions. Just on two cholesterol meds and watch my diet. Your awful young. Good Luck 🍀
And aspirin
@@sherrid5315 3.1 cm
@@Mb44069 Mine is aorta root . Is it your root? If so that’s fairly small. My mothers was her stomach and she did not want surgery to complicated because she had many health issues. And they didn’t find my brothers until it was getting ready to rupture at 10.1 and had to take him to a different clinic and have emergency surgery. He never knew he had it.
@@sherrid5315 I was a bodybuilder for over 10years. Its a tough and unhealthy lifestyle esp when your trying to get big/over 125kgs. Im now 37 had Left ventricular hypertrophy 4 years ago and some other heart issues, I reversed those as it seems from my recent MRI but I now have an An Aorta of 5.6cm No mention of surgery as I havn't been to the Dr(no appointments available until next month) about it yet. You mentioned your brothers was 10.1cm?. Wow thats big. What size is he?. I'm now 96kgs 5.11". When I had LVH I was 125kg very muscular
Hi dear
MY Accendung arota size is 5.2cm, my age is 40b, now the question is what I should do, should I go fir surgery or it can cure with Medicine, kindly reply.
Mine is 4.8 at the root. It's crazy because I don't smoke or drink and it's very healthy and active at 5'7 age 38. Well to answer your question the doctor will monitor you every 6 months to a year to see if it grows or stays the same. Also put you in beta blockers and restrict you from smoking, drinking heavily and lifting heavy weights. If the size gets to 5.5cm- 6.5cm then it is considered critical size and surgery will need to be done.
Three years ago I had mitral valve repair and they put in a pacemaker and annular ring, the echo results had this;
"Aortic root dimensions appeared to be at the upper limits of normal (diameter 3.6 cm). Ascending aortic dimensions appeared to be at the upper limits of normal (diameter 3.5 cm). Aortic arch dimensions appeared normal (diameter 3.0 cm)."
My aortic root aneurysm is 5cm. Currently in "Watchful Waiting" until it gets to 5.5cm. I love cycling, but exercise has been curtailed 🥲
Mines 4.5. I've been told not to lift any weight. Only in very early 40s. Bit scared