hello
Has anyone had or have a dilated aortic root of 4.3. I have and am very frightened I may have to have it operated in. No one has said this and don’t seem worried, but I am! It is slow growing I have had it noticed 11 years ago and at that time it was 4.
I’d be really grateful to hear from anyone with similar. I’m 77.
Thank you
No one is worried because there is nothing to worry about. 4.3 is just mildly dilated and the rate of growth is extremely slow.
I have a similar situation with my ascending aorta and even when they once thought I needed open heart surgery for blocked arteries, they were not going to touch my aorta because it's such a major procedure.
Of course you should keep an eye on it with periodic monitoring, make sure your blood pressure is under control and probably best not to do heavy weightlifting or explosive exercise exercises such as HILT. At least that's what I was told.
But other than that, at 77, I'm sure you have a lot more important health issues to worry about than a mild, slow growing dilation. I certainly do.
Jim
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My own aorta is dilated in the tubular ascending aorta - currently stable at 4.8 cm. Since my diagnosis more than 5 years ago, I have read the medical guidelines and followed some of the discussion of them. However, I am not a doctor and what I'm going to say is for background to explain what they may be thinking about and not any kind of replacement for their advice.
Enlargement at the root is taken a little more seriously than enlargement higher up.
This is reflected in the latest (2024) European and international surgical guidelines which lower the threshold for operations by 2 or 3 mm for aortic root dilation compared to dilation higher up in the ascending aorta.
The usual threshold for surgery has for some time been 5.5 cm, though your height is taken into account, with a different approach for children. Some centres will be open to operating on adults from 5.0 cm upwards, and if the aortic valve needs to be replaced at the same time that may fall to 4.5 cm. In younger patients (well under 60) where there is a family history of early aortic disease and/or evidence of a high risk genetic vascular or connective tissue disorder, the threshold can fall even further. Rapid growth can also be a reason to operate - but rapid would be 3 mm or more in each of two successive years, or 5mm in one year, not 3mm in 11 years. Symptoms are also relevant, if they don't have any other cause.
Your aorta is, on the face of it, nowhere near the size where an operation would be offered, and is growing at a normal rate for someone of your age. I can understand why your doctors would not be concerned. If your doctors are telling you it's unlikely you will ever need an operation for this, they have good reason and evidence behind their advice.
Hope this helps!
Here's a link to the surgical guidelines (open access, but very long!): academic.oup.com/ejcts/arti...
Goodmorning...I just wanted to say what a fantastic post..
Hi Mjames, I was diagnosed 3 years ago with 4.3 dilated root and another one which is in the arch 3.9. Recent scan shows root 3.9 and arch 4.1. Given my age, 80, I’m not so fixed on the numbers, which I was in the early days of diagnosis. These tests can show slightly different results each time. I do understand your stress but honestly you will learn to live with the diagnosis much as you may not think so at the time. It’s a different story for the younger members of this group who have their whole lives before them. However, medical science is advancing at the speed of knots so the diagnosis is actually a plus in that in can be monitored and operated on when the time comes. Take care and live life to the full!
I was found to have a dilated aortic root of 5.8cm aged 52. I did need OHS and was subsequently found to have Marfan syndrome. Yours appears to only have increased by 3 mm in 11 years which is minimal. The important thing is it is being monitored but you may not get to the point of needing an operation. Wishing you all the best.
4.3 up from 4cm in eleven years is absolutely nothing to worry about. Mine is severely dilated and I’m awaiting valve-sparing surgery in the next few months. I have been over 5.5 for quite a while and they still weren’t in a rush to open me back up.
Much as everyone else's posts.
One thing to add is to know your blood pressure and keep it well under control, preferably 120/80.
thank you all for your kind comments. Although it has been a slow trajectory up until now it’s started to grow which worries me. Everything I read (yes I know I shouldnt ) tells me that 5 is the limit, especially for women apparently.the thought of ohs terrifies me but the alternative more so.
That said you have all reassured me. thank you for taking the time to write. And all best wishes to everyone x
"Everything I read (yes I know I shouldnt)"
No, you definitely should. My aortic dilation was the only health issue of mine that I never properly researched for myself. I trusted the (then) 5.5 cm dimension, and I dissected "unexpectedly" (which in hindsight really wasn't unexpected). Had I been more realistic about the risk of dissection, my emergency diagnosis would have been quicker and the outcome better.
Contrast this with my A-fib, where I did a lot of online and other research which had direct benefits in that I got an ablation in Bordeaux in 2002, when they weren't really being done in the UK. Gave me 15 good years in rhythm (until my dissection).
Yes, do your research, but of course use reliable sources. IRAD is a good source, (iradonline), the International Register of Aortic Dissections. They published a paper in 2007 saying that 60% of dissections happened below 5.5 cm, which has helped move the intervention diameter to 5 cm (for high-volume centres), though it took far too many years to make this adjustment, in my view.
Knowing where you realistically stand also allows you to "hope for the best, plan for the worst". With my dissection, both I and the hospital thought it was a heart attack and I never even recalled my dilated aorta. After 2 days in hospital on the basis of a heart attack & stent but with continuing pain they wheeled me into the the CT room, and I thought, I know what that machine is... Nurse! Something I need to tell you...
No, really that's exactly how it happened.
I am 79 and have an AAA of just over 5cm. With other heart and health conditions (I have coronary artery stents) and having had certain suitability tests it seems I am not a good candidate for either of the 2 types of recommended surgery. I am not stressing about it and I am on 6 monthly ultrasound check ups and various meds for blood pressure etc. All the best.
Valve Sparring Aortic Root Replacement.
50mm Aortic root Aneurysm
Understanding Aortic Root Dilatation 
Waiting list for open heart surgery - AortIc valve replacement & aortic root surgery
