Indications
Indications
The decision to replace the ascending aorta is based on a number of criteria, namely symptoms, size, growth rate, and family history.
Symptoms
In the setting of an ascending aortic aneurysm, chest pain is a concerning symptom and may prompt definitive repair urgently. If you have an aneurysm and are experiencing chest pain, you should contact your physician or the nearest emergency room immediately.
Size
While there is no absolute size cutoff, most surgeons will begin to recommend repair of ascending aortic aneurysms when they reach approximately 5cm in size. For patients with Marfan's Disease, surgery may be recommended for smaller sizes. Patients undergoing cardiac surgery for other reasons, primarily those with bicuspid aortic valves, may require concomitant aortic replacement at smaller sizes. Patients with ascending aortic aneurysms greater than 4cm should be followed with CT scans at regular intervals to evaluate growth of the aneurysm, as directed by their physician.
Growth Rate
The rate of change in size of an ascending aortic aneurysm may also influence the timing of surgery. Generally, the faster the aneurysm grows, the sooner it should be repaired.
Family History
Operation may be recommended sooner based on a patient's individual family history. Those with history of genetic diseases, such as Marfan's, Ehler's-Danlos or other family history of aortic diseases may be candidates for surgical treatment earlier in their course.
More about ascending aortic aneurysm: Causes Indications Surgical Treatment Neurologic Protection
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