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- เผยแพร่เมื่อ 11 พ.ค. 2021
- The aorta is the main blood vessel that provides blood to the rest of the body. When you get an aneurysm in your aorta, it can enlarge to the point of rupturing. An ascending aortic aneurysm happens very close to the heart, which is a high-risk area. The Aortic Center at UVA has the expertise and experience needed to excel in aneurysm repairs. Cardiac surgeon Kenan Yount, MD, walks us through the causes, treatment options, and recovery process of ascending aortic aneurysm repair.
Find out more at: uvahealth.com/services/aneury...
Transcript
The aorta is the main blood vessel that comes off the heart. And the very first part thatcomes off the heart above the aortic valve is the aortic root, followed by the ascending aorta. And so that area of the aorta right next to the heart is obviously high-risk territory.
An aneurysm simply means that the aorta is larger than normal. And we know from studies and real-life experience that larger blood vessels are more prone to both rupture or tearing. Tearing, medically, we call a dissection.
We frequently will do surveillance on aneurysms for several years, and try to look at the rate of growth that the aneurysm displays on CT scans. Or we also may instead look at the absolute size criteria of the aorta. And that gives us a good guide as to when to replace the aorta. And we try not to replace it any sooner than we have to, balancing the risk of doing a surgery against the risk of the aneurysm rupturing.
If untreated, an aneurysm can sometimes enlarge to the point where it is likely to rupture or tear. In either of those scenarios, it could be life-threatening if one of them were to happen before we had a chance to replace the aorta.
Ascending aortic repair is probably one of the largest procedures a patient could have, and it can be very complex, depending on the extent of the aneurysm. Over the years, we've made a number of advances in how we both protect the heart and the brain during these surgeries. UVA is really at the forefront and leading the advances of both cardiac protection and cerebral perfusion.
Ascending aortic repair can take anywhere from four to five hours. Patients frequently go to an intensive care unit for the first night or two after their operation where they're closely monitored, and then they can recover for about another three days on a regular ward bed. Overall, recovery can take anywhere at home from four to six weeks. And usually we try to start cardiac rehab at the six-week mark to get patients back on their feet and going again.
Given both the risk of stroke and the risk of cardiac damage during these procedures, UVA is ideally suited to providing both surgeries, be it open surgery or interventions which are more minimally invasive. We have a fair amount of expertise collected over the past 20 to 30 years that have allowed us to do this in a much safer fashion than the surgeries used to be done.
My name is Vahe Emmian and this is my story.
At 45 (27 years ago), in Montral Qc, doctors found that I had an ascending aorta aneurysm of 9 cms! (my only symptoms were fatigue, short breathness and sometimes, slight chest pain.
Drs replaced the section of the aorta and the aortic valve with metal ring and dacron, I think.
I recuperated relatively well, without major physiotherapy
3 years later, I had a pseudo-aneurysm (the original aneurysm failed and blood ran in a cavity behind the heart and formed a PA.
My doctor was hesitant first because of reopening my chest and the risk of rupturing the PA, but following mutual assessement, said he would do it.
3 months later, I had a minor heart attack (right ventricular coronary) and recuperated well.
In 2012, I suffered yet another situation (called widow maker!) qusy obstruction at the forking of the coronary on the heart.
My new young surgeon assessed my history and proposed a less invasive operation: entering under my left arm and proceed with a double bypass, in situ, without extra- sanguinating(?) procedure. I later heard that it was his expertise!
He told me that all what I have gone through is due to the original size of the main aneurysm, which had damaged the surrounding tissue.
In 2018, I yet went to a major operation called 'redo' which us basically starting all over again replacing the aging aorta section and the valve...
Except, this time was not as easy: 3 surgeons, 17 hours under the scalpel, enormous amount of blood loss, heart electrical system collapse (I'm with a pacemaker now),
in the coma for several days, all internal organs failed but recuperated eventually, total weakness for weeks, but here I am still ticking and kicking...
Do not dispair and believe in the medical advances and THINK POSITIVE and LOVE LIFE, someone is probably watching on you.
Omg. That's a lot you've been through. But you're alive and kicking and that's what matters. Stay strong. 💪👌
Wow. God bless you 🙏 u are a fighter fr.
Respect my friend, thank you for sharing.
God Bless You 🙏🕉️🎉
My aorta ruptured in 2017, I was airlifted to Henry Ford hospital in Detroit. I was in a coma for a week after surgery and in the hospital for a month. I am so grateful to my cardiovascular surgeon who safed my life.
Were you aware of anything prior to that happening? Any idea what the size of your aorta was?
@@yoavs6271 the day before it happened i had chestpain, so I went to the emergency care, they send me home after they did an EKG, and I do not know of the size of my aorta.
🎉🎉🎉🙏🏾
Glad you made it. I was in the UP last year and had a surprise dissection, I ended up in Traverse City having OHS. We are lucky to have survived this.
You are so lucky to have survived a dissection. Most patients die before they make it to the hospital. Glad you're still with us.
This physician explained the seriousness of an aortic aneurysm while doing it in a calm and assuring manner.
I have an ascending aortic aneurysm size 4.3 when initially discovered. Actually I thought I was just gonna die right then and there.
Already have fibromyalgia and suffer chronic pain so totally not wanting any type of surgery. Last catscan measured 4.1 what the heck, these don’t shrink.
Must be God shrinking it up
At any rate I just try to go about my normal life, we’re all gonna go at some point. The hardest part with this thing is limitations. On my good days I like to garden to include digging, lifting and when no ones around to help it stinks lol
I wish you all well, peace and healing and successful procedures whatever they may be. 🎉❤
Was it aneurysm or just dilated. Mine is dilated to 4.2. My understanding is it’s not necessarily an aneurysm yet
@@genxcurmudgeon166I just had my annual electrocardiogram yesterday and my results are in Before I see my cardiologist next Tuesday. Of course I am worried what she will say. Mine is 4.1 runs in my family . Lost my mother but they caught my brothers he never knew he had it. Ready to rupture his was 10.1 emergency surgery. Did your cardiologist say yours is ok? Just curious. Thank you
Hello!
Look for EDTA chelation!
I read that it can cure an aortic aneurysm.
Get well soon!
@@genxcurmudgeon166
If it’s dilated it’s an aneurysm - they usually monitor and operate after 5.0-5.5
@@TheDownwardSpiral2005 well I did read that it has to be >50% of the original size to be considered and aneurysm. So if it is supposed to be 3 mine would have to be 4.5 or > to be an aneurysm. Obviously I’ll have to keep an eye on it
I told my dr. About the type of operations for Aneurysms they show on youtube he said they were crap and to stop watching them I believe him
Whaht should i do i have an aneurism situated on the arch of the aorta measuring 86 mm ! I was told that it would be dangerous to be operated because i could end up paralyse ! What the hell ! Plus i do not have money to go to hospital ! What the heck !
@1:36 Mine didn't rupture. I caught some warning signs mostly (sweating, extreme fatigue, and some annoying heart beats that were not picked up on by the halter monitor). My initial read was a 4.7 unclear read, and I was immediately scheduled for a nuclear dye scan which showed a reveal of 5.4 and my surgery to correct was schedule for 8/14/2013, and I was 34. I only had two issues with surgery, well three if you include me finding out I was allergic to tramadol and refused to take it in the hospital. I had suffered from CO2 poisoning twice, and that hurt me and my lungs more than the surgery. Finally, I was thought to be having an infection due to fever, when it was the hospital forgetting to put the AC in in the summer time.
I have one 3.9 xm, root ascending anneurysm. I am not quite there yet for suggery, but i am super scared of everything i read. I really want to avoid open heart surgery!! It seems that for abdominal and descensing torax ones, there non invasive solutions....what about for ascending aortic anneurysms, does anyone know of new or possible minimally invasive procedure?
@2:30 I worked until 8/13/2013. I had my friends at work wishing me good luck, and so on. However, what I remembered the most was guys who did tours in Iraq or Afghanistan or both coming to me wishing me luck, but also asking me if I was scared about the surgery. I replied with a no, and asked why? They said, "well, you're having open heart surgery tomorrow, I know I would be." I said back, if I do nothing I have a 100% chance of dying. But, if I have the surgery to forgo that situation, I only have a 5% chance, as a gambler I like those odds.
I am glad you are well
Plz tel me doc my ascending aorta annyrisam is 45mm Plz sajest me sargari yes or no.answer Plz. Any time chest pain
That's good news
❤️
Can a rupture happen in over a year after a 4.0 cm diagnosis? Diagnosed 2021.
Is it also possible for an MRI to be given 5 years before the diagnosis in 2021 and for the 4.0 cm aortic aneurysm to be missed by the MRI?
I went to the doctor from 2009 through 2017 with chest pains, vomiting and heart attack symptoms and I was given an chest MRI once around 2013-2015 . Nothing seen until 2021.
Hello, if you have a 4.0 and it happens to dissect or rupture within a yr it's growing way too fast. Usually these tend to grow less than 0.5 centimeter per 2 years. This is why they give you blood pressure meds rather than do the surgery because the surgery itself is complicated. I also want to say that if you had an MRI done a year before and you want to know if they missed anything, all I can say is that MRI nor an X-ray is good at detecting aneurysms. The only good way is a CT scan. Please let me know how you are doing now. The one I have is 4.1
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?
You need to lose weight first God bless
No, I lost a dear friend after that surgery she was never the same. She didn’t even have an aneurysm so I would say pls no
My mum is going to have open heart surgery and she has a 10% chance of death,ik it doesn't sound like alot,but still worried I can't lose her and I'm only 17😣
Don't worry she's going to be just fine 🙂. I've had this operation 3 times.
@@MsRustynuts I hope so,thankyou
If she is healthy and in the hands of good doctors, she should make it. I also feel you. My Dad has an aneurysm and I too am 17. He is doing fine though and isn't having open heart surgery anytime soon. (Hopefully)
@@MsRustynuts
For what you got operated for three times…
My son has Ross operation and after that he has arota root dilation.. every 6mo that we r going for checking …
Can you give more info …please
Hello!
Look for EDTA chelation!
I read reports of people who reversed heart disease with EDTA chelation and that thanks to this, it was possible to avoid surgery!
May your mother get well soon!
Can I have weight loss surgery if I have Ascending aorta measures 4.1 cm@ 3.1 cm distal to STJ ?
No....your heart wouldn't handle the pressure
Ask your cardiologist.
No
They found an aneurysm on my heart 2 years ago 4.9 cm. What symptoms do I need to watch for and what I need not to do for it to rupture or grow?
I was supposed to see my cardiologist for the 3rd time 2 weeks ago but I’m having insurance issues. Lately, I’ve been periodically having double/blur vision out of nowhere and oddly jaw pain. Not concerned it’s due to my heart but any ideas?
@@michaelkruz2563 I know it's been 2 months, but have you seen your cardiologist yet? And if so, what did they say?
@@SeattleMartin walking will be fine but just don't do anything more strenuous like lifting heavy things off the ground.
Your dr. Should have talked to you about that and probably did
My mother was always told not to lift anything heavy she did anyways . Did not want any surgery. Hers was to complicated. I lost her 4 years ago sadly 😢
Hi dr.i was diagnosed of Thoracic Aortic Aneurysm its size is 4cm.am i safe or go with open heart surgery...
Unless it's increasing rapidly, open heart is not required until it gets to 5cm.
@@SeattleMartin Same with my Dad, but it's 4.5, slightly smaller.
@@Maw0 Did it take a while to grow I have one at 3.5 discovers two years ago. 2:37 2:37 2:37
Discovered .
My age is38years
That's Ascending EEG
I'm fucked ...
I hope you’re ok.
Jesus touch you
Why? What happened?
life is life brother. One day everyone has to die. Death is just a new area to explore. Make the most of the time you have left, and great death like an old friend. Thats all you can do.
@@SeattleMartin npbody knows what happens when you die. Death is an oppurtunity to find out. And if nothing happens, then oh well, you wont even know shit.
Drs these days speak so coldly about life impacting detrimental conditions we suffer today
❤️