Tuesday, November 2, 2010
Please be aware of the type of imaging that you are having--the pros and cons. Is this the best for you? Make sure the data that is being retrieved from the CT scan or MRI is accurate and decisions on your health are based on confirmed and accurate measurements and trends..... Get a second opinion from a reputable aortic center that publishes its data and has a passion for your disease. Be safe...
Sunday, October 31, 2010
There is very little evidence to suggest that bicuspid aortic valve patients need different treatment than patients with a "normal" aortic valve. The studies that indicate that the risk of aortic dissection was higher in bicuspid aortic valve patients were old, autopsy studies that definitely provide a bias view on the subject. There are numerous studies in patients who were followed and the growth of their ascending aorta was measured and clinical outcomes were measured. There was either no aortic dissection or other aortic complications during their follow-up. There will be a article coming out in the Annals of Thoracic Surgery from Dr. Griepp and the Mount Sinai Aortic Group in the next couple months related to this topic. Patients with bicuspid aortic valves can be followed carful before they may need surgery.
Tuesday, October 26, 2010
Most patients have a significant amount of anxiety when they are informed that they have an aneurysm. If the aneurysm is too small to require surgery-diligent medical therapy is appropiate. Enrollment in an established aortic surveillence program is prudent. The annual CT scan or MRI can provide a great deal of reassurance that medical therapy is working. Please take charge of your care by seeking the appropiate aortic team. Look at my previous posting for aortic centers in the US.
Monday, October 25, 2010
Monday, April 26, 2010
Monday, March 22, 2010
Sunday, February 28, 2010
Always ask your cardiologist or cardiac surgeon prior to signing up for surgery what are your risk if you continue conservative management of your aneurysm. Many times surgery is performed because the individuals taking care of you are nervous about leaving the aneurysm alone and continuing surveillance. I hear this often when people come to see me for a second opinion. Most of the time I recommend conservative management and place the patient in our surveillance program. So be careful who is recommending surgery and how many patients they are treating with aneurysms. Many 5 cm ascending aortic aneurysms can be watched carefully. Seek a second opinion from an aortic reference center.
Tuesday, February 23, 2010
The ascending aorta has a normal diameter in the range of 2.0 to 2.5 cm. A diameter which is double this diameter is considered an aneurysm. All aneurysms must be followed carefully with serial echocardiograms, CT scan or MRI. The frequency of the surveillance study is dependent on symptoms, family history of aneurysm or dissection, size of the aneurysm, and the cause of the aneurysm. Your cardiologist or aortic specialist would set up an appropriate schedule.
Monday, February 15, 2010
Saturday, February 13, 2010
Thursday, February 11, 2010
As I mentioned, the winter months it is more common for physicians to care for patients with acute aortic dissections. The patients who were more likely to develop a dissection during these months were woman, age less than 70, without diabetes, and normal blood pressure at the time of presentation. You can find this information in a study published in Circulation, 2002.
In the winter months it is more common to experience an aortic dissection. The proposed reason for the increased incidence is a change in blood viscosity and elevation in heart rate and blood pressure. Also, it is more common to have an aortic dissection in the morning hours.