Aortic Root Dilation

[scottpdn]

Hi,

I have a mechanical aortic valve (surgery in 2014). I’ve recently had an echocardiogram and have just received a letter with the results. It says my aortic root is ‘mildly dilated with a dimension of 40mm at the level of the sinus of Valsalva’. This seems new - it hasn’t been raised in previous echocardiograms.

Can anyone tell me what this means and what I should do next? The letter just says I will be seen ‘in due course’.

[JulianM]

The main function of the aortic root - which is a three-lobed structure between the heart and the ascending aorta - is to support the three leaflets of the aortic valve. It also gives rise to the two coronary arteries.

However, since you have a mechanical valve, the structure and functioning of your aortic root will be different and depend on exactly how the surgery was done.

Enlargement of the aorta following heart surgery, especially surgery on the aortic valve, is a known issue and it sounds like you are being monitored appropriately. For as long as your valve continues working properly it hopefully won't be a problem at the size you mention, but of course it will need further checks in case more growth follows.

You might need a further scan - either CT or MRI - to get a really accurate measurement; echos are very good for assessing blood flow and valve function, not so good for aortic size (although the root is one of the areas which can usually be seen pretty well on echo).

This is certainly something you need to discuss with your doctors, but not a crisis.

Hope this is helpful!

[scottpdn in reply to JulianM]

Thank you. There are some scary results when you google this, so it is reassuring to read your reply.

[JulianM in reply to scottpdn]

Most aortic root dilation - where there has NOT been previous surgery - is genetically driven, especially where younger adults are involved, and raises a different set of issues. Unless you have a family history of aortic disease, that isn't relevant to you.

[Snoogs]

… from my experience a little over 4 years ago I was diagnosed with an aortic root aneurysm through an incidental finding. At 5.9 centimeters I had to undergo surgery to repair it. Your dilation at 4cm will most likely be monitored over time to measure the velocity of growth if any. As I understand it they (surgeons) threshold to take any action is over 5 or 5.5cm. I know people who have had a dilation remaining stable for many years (15 +)and no action was warranted to date.