[HSF] Ascending Aortic Aneurysm

[bbiocina at kbd.hr]

Steve ,
some data  from ECHO is  missing ; how big the transvalvular gradient is?
is there any calcifications of leaflets? any hypertrophy of the LV? the
lower origin of the aneurysm-sinuses or sinotubular junction? -all that 
should be taken into account.
As the stenosis is mild by definition , you should  have in mind  that 
mild stenosis in younger  patients  might be  slowly progressing.
In a study of 142 patients with "mild" stenosis (catheterization-proven
AVA >1.5 cm2), the rate of progression to severe stenosis was 8 percent
in 10 years, 22 percent in 20 years, and 38 percent in 25 years.
Rahimtoola,S.H.,Aortic Valve Disease,Hurst's Diseases of The Heart,10th
Edition,Vol.2,Pp.1682-1695
Also , the type of operation you plan  should be  considered  if you opt
for valve replacement- Bentall or valve + tube graft.
Of  course  you can  apply  the "why not" principle , but in that case 
a natural history of  various  tissue valves ( advantages  and
disadvantages of mechanical valves  have been better defined) shoud be
taken into account.

Bojan

On 5/1/2007, "Steven Schwartz" <smschwartz at mac.com> wrote:

59 yo male with "atypical chest pain" had CT scan of chest done. 6 cm
>ascending aortic aneurysm identified, reportedly ends at level of
>innominate artery.
>My question centers around a recent echo which showed an aortic valve
>area of 1.4 cm2.
>Should the valve be addressed? Just a "tube graft"?
>Steve Schwartz
>
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