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Diagnosed with dilated aortic artery. Have mechanical valve at the aorta. What is the surgical treatment?

May 2014
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I am a 79 year old male who has been diagnosed with an dilated aortic artery at the connection to the heart. I have a mechanical valve at the aorta put in about 10 years ago. My most recent measurement of the artery at the heart area is 5.2 cm at it's widest point.
My questions are what is normal and what is the surgical treatment?
Posted Wed, 17 Jul 2013 in Hypertension and Heart Disease
Answered by Dr. Vivek Chail 7 hours later
Thanks for writing in.

From your given medical history, I understand that you are a 79 years old gentleman having undergone aortic valve replacement in 2003 and presently having congestive cardiac failure and dilatation at the root of aorta where it measures 5.2 cms.

There are two medical entities involving the dilatation of the aorta at the connection to the heart. One is aortic root aneurysm and the other is supravalvular aneurysm of the aorta. Based on your general description I suppose that you have aortic root dilatation.

As per guidelines, in a patient with aortic root dilatation, if mild to moderate, treatment with β blocker medication and serial follow‐up with echocardiography once or twice a year is recommended.

The normal measurement value of the aortic root is around 3.5 to 4.0 cms. Now this is a relative range and it depends more on the growth stability of the aortic root diameter with age. The measurement is not static but grows very slowly even with normal ageing and may be 1-2 mm per year. In other words a person with aortic root 4.0 cms for 2-3 years is in a safer position than someone who's aortic diameter measured 3.5 cms last year and today it measures 4.5 cms.

Underlying cardiovascular risk factors should be aggressively controlled. Basic lifestyle activities may be modified, because high intensity, competitive and collision sports are potentially XXXXXXX and may precipitate aortic dissection or rupture, a life threatening condition.

Surgical treatment of aortic root dilatation is required as
1. An elective procedure when the root dilatation exceeds 5.0 cms to 5.5 cms as per the cause of the problem. Also when the root dilatation is growing more than 1 cm per year.

2. Emergency surgery is required when there is rupture or aortic dissection, unexplained pain or compression on other organs by the aortic root dilatation.

In this surgical approach, there are two types of surgery, either radical, replacing the aortic valve and root; or conservative, replacing the aortic root while sparing the aortic valve. In your case the aortic valve is already replaced so only the aortic root may need a surgical replacement using a composite graft.

I have tried my best to make our discussion simple.
Wishing you good health.

Further questions welcome.
If you don't have any more questions, I request you to please close this thread and post a feedback.

Dr Vivek
Above answer was peer-reviewed by
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