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Dr. Andrew Rynne

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Does open heart surgery for aortic aneurysm in ascending aorta result in cognitive difficulties?

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Dr. F. Sadruddin Shariff

Cardiac Surgeon

Practicing since :1989

Answered : 31 Questions

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Posted on Thu, 14 Feb 2013 in Valvular Heart Disease
Question: does open heart surgery for aortic aneurism in ascending aorta result in cognitive difficulties? What is recovery time? What is risk?
doctor
Answered by Dr. F. Sadruddin Shariff 10 hours later
Hi,

Thanks for the query.

Open heart surgery for Aortic Aneurysm need not always give rise to cognitive difficulties. It depends upon the extent of the aneurysm and hence the need of it being done just under a standard cardiopulmonary bypass(CPB) or does it have to be done under total circulatory arrest if it is more extensive. The surgery, if it can be done under standard CPB does not have much risk of cognitive behavior dysfunction postoperatively, whereas there is a higher risk of the same if the aneurysm is extensive and is upto or if involving the arch of the aorta.

The discharge from the hospital can be in about 8 to 10 days, but resumption of normal activities and work may take from six to eight weeks.

The risk again depends upon the extent of the disease. If the complete CT SCAN report may be uploaded further guidance can be given.

Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. F. Sadruddin Shariff 3 days later
My aneurysm involves the lower part of the aorta and the lower part of the blood vessel that conducts blood to the brain. Would this require "total circulatory" arrest?
I have uploaded my latest CT SCAN report. The aneurysm involves the lower part of the aorta along with the lower part of the blood vessel branch off to the brain. It is growing about 2mm/yr. My cardiologist thinks that I will require surgery to correct the aneurysm in about 2 years.
Is it possible to avoid opening the aorta by applying a sheath to the outside of the aorta? I saw an article that claimed to do that with a sheath fabricated using rapid prototyping techniques and a laser to measure the proper size.
I weigh 205 pounds and am 75 inches tall.
doctor
Answered by Dr. F. Sadruddin Shariff 37 hours later
Hi,

I am sorry, I am unable view your reports. Kindly re-upload them. You have a feature to upload the reports by yourself on the right side of this query page. Please utilize it.

Alternatively, you may mail your reports/images to YYYY@YYYY with subject as "Attention to Dr. Sadruddin Shariff".

I would like to have a clear picture, before concluding.

Regards
Dr Sadruddîn

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. F. Sadruddin Shariff 10 hours later
Hello Dr. Shariff,

I have attached a copy of my 2-page CT Scan report. I have also uploaded them again.

Thank you for your attention,
XXXXXXX
doctor
Answered by Dr. F. Sadruddin Shariff 10 hours later
Hi,

I have gone through your reports and I can conclude that at present you do not require surgery or any intervention as rightly said by your cardiologist. The indication of intervention depends upon not only the size of the aneurysm but also the rate of its expansion usually about a cm per year. It is sufficient to monitor closely the aneurysm with a scan every six months or so.

Coming back to your question of cognitive disorders postoperatively, the scans reports uploaded do not mention the vertical extent of the disease, it is at the level of the pulmonary artery, that is what I gather and hence I may not be able to tell you the exact intervention you require. However the incidence of cognitive dysfunction is the same and there appears to be no difference in their occurrence either with open surgical methods or endovascular approaches.

The method to which you are referring to is known as waist coat aortoplasty or reduction aortoplasty with external wrapping, and this is done in borderline cases and who also require some other simultaneous cardiac surgery. The gold standard has been right royal and traditional ascending aortoplasty when indicated absolutely. In good hands and so much of technology around the incidence of postoperative complications are bare minimum now.

Please feel free to ask and follow up on the same anytime, all the best and good health to you!

Regards

Dr Sadruddin Shariff

Above answer was peer-reviewed by : Dr. Shanthi.E
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