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Having Pacemaker. Taking Pravastatin And Alprazolam. When Aneurysm Has Been Repaired, Slightly Larger Than A Normal Aorta.?
Question: I am a 74 yr. old male.other than a pacemaker,since sept 2012,i have generally been healthy.my b/p stays @ approx.130/75.my meds. is 40mg pravastatin daily.0.5mg alprazolam for anxiety.in nov. of 2004,ihad a AAA repaired.each yr in nov. I have had ultrasound performed and it has stayed stable.this last nov. they said there was a "kinking"in the renal arterie and they (in reference to my vascular surgeon) wanted a followup done inapprox. 6mo.i was not and still do not have any symptoms,but he wanted to keep an eyeon.which I agree with.however when checked on 6/13/13 they noticed tha my aneurysm had increased in size to 4.5 cent.,but ,it is not leaking.my surgeon is out of town and will not return until 7/9/13.my question is,when an aneurysm has been repaired is it slightly larger than a normal aorta.?with the mesh inserted is it able to withstand alarger increase in size ,before having to be repaired and is it possible the kinking of the renal arterie could have had anything to do with the increase in size?
I guess I just wan to know how concerned I should be at this point ?
I guess I just wan to know how concerned I should be at this point ?
Hi and welcome to XXXXXXX Thank you for your query.
First, considering all these I think that this is not something to be concerned esecailly if you dont have symptoms. Aortal aneurysma <5cm isnt indication for surgery. If there is a leaking this is very bad sign,but this is rarely seen after adequate surgical procedure.
There was probably Dacron prothesis graft inserted, there are prothesis sizes from 2-5 cm and usually the surgeon choose 0.5cm-1cm larger one than your normal aorta is.
The postoperative alteration in the size of such grafts is possible but it is usually minor and it has no some significance in recovery and prognosis.
I dont understand was it measured 4.5cm at the location where prothesis was inserted or the natural aorta was measured? In both cases,this is not something that will effect blood flow or increase the risk of rupture. It should just be checked by US 1-2 x a year. You didnt mention the initial size of aorta postoperatively but if there is slow size enlargement(<0.2cm a year), such it is in your case since it grew only for about 1 cm in 9 years, you can expect favorable outcome.
Kinking means that renal artery is bended and it can cause blood flow abnormality sometimes but it can be easily checked by dopler ultrasound. This is usually asymptomatic and if your kidney functional test are normal, you dont have to worry. This is commonly seen after such surgeries especially if reconstructon of renal artery was done or if the proximal anastomosis was close to the origin of renal artery. It should also be checked by ultrasound or CT angiography.
WIsh you good health. If you have any questions I ll be glad to help. Regards
First, considering all these I think that this is not something to be concerned esecailly if you dont have symptoms. Aortal aneurysma <5cm isnt indication for surgery. If there is a leaking this is very bad sign,but this is rarely seen after adequate surgical procedure.
There was probably Dacron prothesis graft inserted, there are prothesis sizes from 2-5 cm and usually the surgeon choose 0.5cm-1cm larger one than your normal aorta is.
The postoperative alteration in the size of such grafts is possible but it is usually minor and it has no some significance in recovery and prognosis.
I dont understand was it measured 4.5cm at the location where prothesis was inserted or the natural aorta was measured? In both cases,this is not something that will effect blood flow or increase the risk of rupture. It should just be checked by US 1-2 x a year. You didnt mention the initial size of aorta postoperatively but if there is slow size enlargement(<0.2cm a year), such it is in your case since it grew only for about 1 cm in 9 years, you can expect favorable outcome.
Kinking means that renal artery is bended and it can cause blood flow abnormality sometimes but it can be easily checked by dopler ultrasound. This is usually asymptomatic and if your kidney functional test are normal, you dont have to worry. This is commonly seen after such surgeries especially if reconstructon of renal artery was done or if the proximal anastomosis was close to the origin of renal artery. It should also be checked by ultrasound or CT angiography.
WIsh you good health. If you have any questions I ll be glad to help. Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks
I never thought to ever ask the measurement postop.but,i do believe the measurement was at the prosthetic insertion.
thanks once again
I never thought to ever ask the measurement postop.but,i do believe the measurement was at the prosthetic insertion.
thanks once again
Hi.
Then they probably measured the prothesis and it actually cant expand too much or rupture,this is extremely rarely seen.Also ultrasound is operator depending test and measures are not reliable sometimes as CT scan is. YOu just need to report sharp pain, palpitations or any other strange symptom if you notice and do regular check ups as recommended. This is not something significant and isnt indicating some life threatening condition.Regards
Then they probably measured the prothesis and it actually cant expand too much or rupture,this is extremely rarely seen.Also ultrasound is operator depending test and measures are not reliable sometimes as CT scan is. YOu just need to report sharp pain, palpitations or any other strange symptom if you notice and do regular check ups as recommended. This is not something significant and isnt indicating some life threatening condition.Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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