Aneurysm of the Ascending Aortic Root
20 January 2003
Just wanted to add my experience to the list in case it might help others learn about some of the options out there to treat a problem similar to mine. I am a white male of Mediterranean descent. Around age 44 I had an EKG as part of a routine health screening offered by my employer. They noticed something funny on the EKG and advised me to discuss it with a physician. This led to my physician referring me for an echocardiogram. It came back with a diagnosis of an enlarged aortic root, about 5.2 centimeters. We did some watchful waiting and I began taking medications to lower my blood pressure. I was also about 20 lbs. overweight.
Around age 47, I was advised to have a follow-up echocardiogram. The aneurysm appeared to have grown to about 5.5 centimeters, and I was referred to a cardiologist. Further testing was conducted, and I was advised that it might be time to discuss my options with a surgeon. I decided to look for a surgeon. My brother and sister-in-law helped me find a specialist in aortic repair at the Cleveland Clinic. His name is Dr. Lars Svensson. Dr. Svensson advised me that it was best not to wait. Early intervention would not only decrease the likelihood of an aortic dissection, but by having my surgery now he would be likely able to save my aortic valve. He uses a procedure in which he takes out the aortic value, repairs any tears or small holes in it, and re-implants it in the new aortic root, which I understand to be a dacron prosthesis. He made a relatively small incision in my chest, about 4.5 inches long. I was only partially opened up. I was connected to the heart-lung by-pass machine via my femoral artery in the right groin.
Surgery took place on 6-19-02. It was a success. My heart started spontaneously once they reconnected me. I did not require any by-pass surgery for my coronary arteries as they were in good shape. I have a history of smoking when younger but not in the last 18 years. I also have been doing cardio-vascular exercise (swimming, walking, machines) since age 20. I did have a brief episode of atrial fibrillation two days after surgery, which required that they use electric shock to stop my heart and restart it. I was told that this is not uncommon. I had quite a bit of swelling and numbness in my inner right thigh muscles due to the stretching of the nerves near the femoral artery. However, 7 months have passed and most of the numbness is gone. When the sensations came back in that leg, it was like being poked with needles. But it was a welcome pain. The only symptoms of my aneurysm that I had were shortness of breath which lasted for several hours after exercising. Now that seems to be gone. I have my own valve so I do not need any blood thinners. I am taking a beta blocker and aspirin therapy. I notice now that my fingers do not tolerate cold weather. I am having some side-effects from the beta-blocker which I plan to discuss with my physician the next time I see him.
I am of course very grateful to have been diagnosed early and had such an excellent surgeon. My recovery has been steady and I find that although I was back on my feet walking in no time, it has taken several months to get close to full strength back. I have been advised to avoid heavy (limit of 20-25 lbs.) lifting, snow shoveling, etc.
Hope this information can help someone else wondering about options. I know I wanted to have all the information I could find prior to my surgery. I have been told that I can expect a normal life span.
Update: 28 October 2005
I would like to share an update on my progress in the 40 months since my surgery for an aneurysm of the root of my ascending aorta. My surgery was in June, 2002, and even though I made a lot of progress in the first year, I find that I have recovered even more since then. I am now age 51. My strength is improved and I am now working full time. People can't tell from looking at me that I am on a heart medication and am limited in certain activities. I would say I am leading a very active and normal life, with a few modifications and exceptions.
I try to work out three times weekly, primarily doing cardiovascular activities such as power walking or using the eliptical trainer at the health club where I belong. Being on a beta blocker, my heart rate doesn't usually climb over about 115 beats per minute, whereas before surgery I was regularly getting it up to around 140 beats per minute. I find that my stamina is good, but my power is quite limited. I can exercise for 40-45 minutes with no discomfort. However, I don't do well walking up hilly inclines or carrying things as I get short of breath and my heart can't keep up.
My wife has had to take over some of the things I used to do such as loading bags of mulch or topsoil into our minivan. We get some strange looks at times from sales clerks when she or I ask them to move things or load things that from all outside appearances I should be able to handle. I don't like having to explain that I have a disability in the area of lifting heavy objects, so sometimes I just leave them to their own interpretations.
Most of the time I feel incredibly lucky to still be alive and enjoying so much in life. I was fortunate to be able to see many of my friends this year, despite the fact that they are scattered around the country. My wife and I took a trip to Hot Springs and Little Rock, Arkansas which was very enjoyable, and we stopped in Columbia, Missouri to see a dear old friend. Recently another good friend took me to see Paul McCartney in concert and I couldn't help but cry at my good fortune in still being around to enjoy such a peak experience. It was an unbelievably fantastic concert. Being an old Beatles fan from age 10 and onward, I thought I had died and gone to Beatles heaven.
I now have three adorable grandchildren and am thrilled by this opportunity as well to bond with them and watch them grow up. I tried kayaking in February while we were in St. Lucia in the Caribbean. I was not able to sustain the power to paddle successfully and realize that I have to give up that dream. But even though I am no longer able to canoe or kayak, I find that there are substitute activities which can be just as enjoyable. For example, this summer my wife and I went tubing on the Platt River in Sleeping Bear Dunes National Lakeshore in upper Michigan. It was another high just floating down the river and holding hands. I am also still able to swim and enjoy water. Body-surfing in Lake Michigan is another thrill I enjoy when the waves are crashing into the shoreline. I just make sure to wear my life vest now so that I have more security in the water.
I work hard to keep my blood pressure in check. I really watch the sodium intake, take my meds regularly, and try to watch the weight, which is always a struggle.
I have recently learned that some other family members have aortic aneurysms as well. I learned that my mother's uncle died at age 50 of this disorder, about two months before I was born. And it has turned up in other family members as well, leading me to believe that there is a gene that I inherited from my mother which expressed itself in my aneurysm. I have encouraged my siblings to have their children screened so that there is a baseline measurement of their aortas.
This is the first year that I have not had to have an annual CT scan. I did recently go for my annual echocardiogram, and am waiting for the results. I am anticipating that everything is stable and that there are no surprises. I see my cardiologist annually.
I live with the realization that my aortic valve may wear out in another 6 or 7 years. This is something that the surgeon warned me about when he reimplanted my own valve rather than use a mechanical valve. So I live with the awareness that I may have to face surgery once again. But it gives me the incentive to live each day as fully as I am able. My wife and I try to travel as much as we can given the constraints of work and finances. We are hoping to go to Europe in 2006 as neither of us has been there before. We are looking forward to a week or more in Paris as our first experience there. That will be another peak! We are anticipating this adventure eagerly.
Thanks for allowing me to share my experiences since I last wrote. I find that this website offers a lot of support and information and I have appreciated participating in this network of caring and concerned people.
Discussion, comments, or questions: John Wakeen
© Copyright 2003 John Wakeen
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