Ascending Aortic dissection

[Alan]

My wife’s sister in Edinburgh (age 65) has just had confirmation that she has an aortic dissection, which is a tear in the inner wall of the aorta coming out of the heart. She sees a consultant on Tuesday for more tests and to get an idea of timing for when the surgery will take place. The additional tests are to see if there is any other work needed to be done while they have her chest open.

She has no symptoms and this has only been discovered because she signed up to a research project over 10 years ago and has been undergoing routine tests and scans from time to time as part of this project. A few weeks ago she traveled from her home to Newcastle (130 miles) where they were trialing a brand new type of CT scan and a day or 2 after she got back she received a phone call with the news and that the results had been forwarded to her doctor. The cardiologist she saw in Edinburgh scheduled her for more tests saying that the fact she has had zero symptoms but is very active with her swimming and hill climbing probably meant that it was a false alarm, but to stop the vigorous aerobic exercise just in case.

https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496

I had never heard of this medical condition before.

 

[razztazz]

John Ritter and Alan Thicke died from it. I would also assume many others who were diagnosed as "death by heart attack" in the olde days, also had it. I have never heard of a case like your wife's sister's before. All the cases I've heard about are sudden and present just like a heart attack.

 

[SecondCor521]

I've been told my grandmother died from a torn aorta. Healthy as a horse until the day she died. Dropped dead in the grocery store.

 

[sheehs1]

This past November right before Thanksgiving, My 38 year old nephew's Father In Law (his wife's Father) had chest pain at a lunch, was taken by ambulance to Vanderbilt, quickly diagnosed with aortic dissection, was in surgery that night and multiple surgeries the next day or so and sadly did not make it. He was in his late 60's, very healthy life style, and had no symptoms of there being anything wrong either. He had taken his grandson to tour China for 2 months this summer, always physically active. Apparently his dissection, as it progressed quickly, went all the way down with multiple organ involvement. Very critical. Everyone was in shock.

I think survival percentages are based on whether it is ascending or descending. His was Descending and I just noticed your heading says "Ascending".

Glad your wife' sister is getting it checked out and hoping that it is a small enough tear that any surgery she may have to replace that part of the aorta will be a positive outcome. Personally after the experience we just went thru, sooner is better than later IMHO.

Please let us know how she is..as she makes her decisions.

 

[Lewis Clark]

My father had this condition. The odds of surviving the surgery were about 10% so he chose not to have surgery. When the surgeon does not recommend surgery, it's a strong hint surgery is not the best course of action. The docs didn't expect him to survive and the family circled the wagons.

Dad was lucky. His aorta healed itself, with a lot of help from medications to control his blood pressure. He made it another decade before passing from a different cause.

 

[Bestwifeever]

My wife’s sister in Edinburgh (age 65) has just had confirmation that she has an aortic dissection, which is a tear in the inner wall of the aorta coming out of the heart. She sees a consultant on Tuesday for more tests and to get an idea of timing for when the surgery will take place. The additional tests are to see if there is any other work needed to be done while they have her chest open.

She has no symptoms and this has only been discovered because she signed up to a research project over 10 years ago and has been undergoing routine tests and scans from time to time as part of this project. A few weeks ago she traveled from her home to Newcastle (130 miles) where they were trialing a brand new type of CT scan and a day or 2 after she got back she received a phone call with the news and that the results had been forwarded to her doctor. The cardiologist she saw in Edinburgh scheduled her for more tests saying that the fact she has had zero symptoms but is very active with her swimming and hill climbing probably meant that it was a false alarm, but to stop the vigorous aerobic exercise just in case.

https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496

I had never heard of this medical condition before.

Wow. So lucky that this condition was serendipitously discovered! DD’s FIL was in a random study of heart disease in Indian adults who live in the USA and his baseline screening disclosed severe arterial blockages and he immediately had open heart surgery. Your SIL’s condition sounds more serious but I hope her healthy lifestyle will contribute to a very successful surgical outcome. Best wishes!!!

 

[braumeister]

Interesting tidbit from wikipedia:

Famous heart surgeon Michael DeBakey originally developed the surgery for this disorder in the 1950s. He later developed it himself at the age of 97 in 2005, and underwent surgery in 2006.

Hoping for the best for your in-law.

 

[jabbahop]

Sorry to hear about your wife’s sister.

I have an ascending aorta aneurism and get checked yearly to make sure is isn’t growing such that I need surgery (I am a couple of mm away from having to have the surgery). They found it 6 years ago when I had a scan to see where my lymphoma was (quite a two-fer finding by the radiologist).

 

[MissMolly]

My uncle died from this about 6 years ago. They got him to the hospital but not soon enough.

 

[samclem]

It sounds like she was quite fortunate to have discovered this before finding out the hard way. Best wishes to her and the family for a good outcome.


Maybe we should all volunteer for various medical experiments to see what they find?!

 

[swakyaby]

From my recollection, ascending aortic dissections are less common than descending aortic dissections and much more complicated to repair. Ascending aortic dissections often involve other major arteries and are so close to the heart that they require a facility and a surgical team that can do cardio-pulmonary bypass. It’s good that the condition was diagnosed while asymptomatic so that measures can be taken to limit the injury, i.e. good blood pressure control.

 

[Alan]

From my recollection, ascending aortic dissections are less common than descending aortic dissections and much more complicated to repair. Ascending aortic dissections often involve other major arteries and are so close to the heart that they require a facility and a surgical team that can do cardio-pulmonary bypass. It’s good that the condition was diagnosed while asymptomatic so that measures can be taken to limit the injury, i.e. good blood pressure control.

She has been told that the surgery will require her to be on bypass and for the heart to be stopped. Scary stuff.

 

[Alan]

Thanks to everyone who has replied, I appreciate all your responses.

 

[TromboneAl]

Has she gotten an independent, second opinion?

The only reason I've heard the term is that doctors referenced in this book misdiagnosed (probably intentionally) spontaneous dissecting arteries.

 

[swakyaby]

Has she gotten an independent, second opinion?

The only reason I've heard the term is that doctors referenced in this book misdiagnosed (probably intentionally) spontaneous dissecting arteries.

The 2 doctors referenced by TA committed massive fraud and medical malpractice by intentionally misdiagnosing coronary artery disease in order to perform unnecessary open heart bypasses. Dissecting aortas were not involved.

 

[Alan]

Has she gotten an independent, second opinion?

The only reason I've heard the term is that doctors referenced in this book misdiagnosed (probably intentionally) spontaneous dissecting arteries.

Yes, she has had 2 more assessments from heart surgeons with what one called the gold standard test for aortic dissections. She has chosen her surgeon and will be having it done in a couple of weeks.

 

[swakyaby]

Have the surgeons described the extent of the dissecting aorta and what other vessels/structures need repair?

 

[Moemg]

Alan , Best of luck to your sister !

 

[Alan]

Have the surgeons described the extent of the dissecting aorta and what other vessels/structures need repair?

Not that I’m aware of, but I’m getting the info 3rd hand via my wife. I think my SIL still has more tests scheduled over the next couple of weeks to determine all that needs doing during the surgery. Once she receives a date then we will drive up to Scotland to stay with her for a while after the surgery. She has a son a couple of miles away and someone lined up to take her in on the day. Her other son lives in California and it is likely he will come over as well, he works for Apple and can arrange to work remotely. He did this a couple of years ago while his dad was in the final weeks of his illness. (Pancreatic cancer)

 

[Elbata]

FIL had the same thing, called Type A aortic dissection. His surgeon Rodney White, the inventor of the aortic stent, operated on FIL (he was 85), saved his life.

The surgery lasted only ~an hour. From my understanding, the stent, much like the stent installed in coronary arteries is inserted and expanded. It expands to ~1" diameter and ~ a foot long.

https://people.ctsi.ucla.edu/institution/personnel?personnel_id=45909

 

[Alan]

All tests now complete and no issues to be addressed other than the aortic dissection while the chest is open. The plan is to remove and replace the damaged section of the aorta with a synthetic tube or graft.

Surgery scheduled for Wednesday. We plan on driving up a couple of days afterwards and be there for a couple of weeks to help with the recovery when she comes home.

 

[Alan]

FIL had the same thing, called Type A aortic dissection. His surgeon Rodney White, the inventor of the aortic stent, operated on FIL (he was 85), saved his life.

The surgery lasted only ~an hour. From my understanding, the stent, much like the stent installed in coronary arteries is inserted and expanded. It expands to ~1" diameter and ~ a foot long.

https://people.ctsi.ucla.edu/institution/personnel?personnel_id=45909

Amazing what they can do these days.

 

[swakyaby]

Best wishes to your SIL for a smooth operation and uncomplicated recovery.

 

[jabbahop]

I too send my best wishes to your family.

 

[swakyaby]

Did your SIL have her surgery today?