Anyone have any experience shrinking their TAA's or remain stable for many years?

[Hercules72]

Hello all, I've recently been diagnosed with a Thoracic Ascending Aneurysm of 3.9cm. I am 52 years old. Quit smoking in my 30's, normal bp. Slightly overweight.. need to lose about 10-15 lbs. Exercise is walking daily 30-40 min. Has anyone seen their TAA shrink over time with lifestyle change, diet, exercise and bp control or at the very least managed to remain stable for a very long time? I find myself very anxious about this new discovery and at 52 years old the future suddenly looks really scary to me.

[JulianM]

As you are in the USA, you might find it more helpful to join a US-based support group. There are some very good charitable organisations which cover heritable thoracic aortic conditions, notably the Marfan Foundation (which has a much broader remit than that name suggests - if you look on their website you will find out about it) and the organisation Aortic Hope. Also check out the John Ritter Foundation. However, do understand that most of their resources focus on the worst things that can happen and on the needs of people with underlying conditions that - while worth checking for when your aorta is oversized - are rare.

Technically, you don't have an aneurysm according to the most recent guidelines such as those from the EACTS/STS (cardiothoracic surgeons) which would define an ascending aortic aneurysm as anything over 4.5cm diameter, and use the term 'dilation' for anything less than that. At 3.9cm you are at the top end of the normal size range, though in the UK you could be eligible for genetic testing to check for high-risk inherited conditions (of which Marfan syndrome is the best known, but there are at least 30 non-Marfan genes that are checked in addition to FBN1, which is linked to Marfan but also accounts for some non-Marfan aortic conditions). In the USA, what tests may be offered probably depends on what insurance you have and who you get referred to. If you have a family history of aortic disease or unexplained early deaths, everything changes and in that case monitoring would need to be somewhat closer and the value of testing may depend on previous findings for other relatives.

Stability or very slow growth is normal: I have personally been stable at 4.8 cm for 5 years or so, with no symptoms at all: this is pretty typical for ascending aortic aneurysms. The risk of dissection in the absence of known genetic risk would be very low at 3.9 cm and surgery would not normally be offered below 5.0 cm. However, you should get a high quality CT scan for baseline measurement, and a follow up a year later to check for unusual growth. Blood pressure control is important to limit any risks associated with this, but aortas don't shrink.

Hope this is helpful.