The following are brief answers to questions patients ask most often about the complex and wide-ranging subject of heart disease, including its risk factors, symptoms, diagnosis and treatment.

Aortic Disease

Bicuspid Aortic Disease

Marfan Syndrome

Thoracic Aortic Surgery

• After having a CT scan I was told that I have an ascending aortic aneurysm that is 4.2 cm in size. I am on a beta blocker and other blood pressure medication. My aortic valve is normal. If I continue on the blood pressure medicine, will it shrink the aneurysm?
• I have an ascending aortic aneurysm. My blood pressure is normal at 120/80. Why am I being given a beta blocker and other high blood pressure medicine if my blood pressure is normal?
• My friend died on the way to the hospital at the age of 54 from an acute ascending aortic dissection. How can I make sure that this will not happen to me?
• Can I still exercise if I have an aortic aneurysm or chronic dissection?
• I was first told that my aorta is slightly dilated at 4.0 cm. I was later told that this is an aneurysm. What is the difference between "slightly dilated" and having an aneurysm?
• On the report from my CT scan, it says that I have a fusiform aneurysm. What kind of aneurysm is this?
• I have an aneurysm that extends from my chest into my abdomen. 
• I am a 56-year-old male and have a 4.6 cm ascending aortic aneurysm. My aortic valve is normal, and I do not seem to have any connective tissue disease. I have never smoked, and always exercised regularly. My blood pressure has averaged around 130/70. What could have caused my aneurysm?
• I am 76 years old and have recently been told that I have a large aneurysm at the top of my aorta. I am healthy except for having high blood pressure. Would surgery be too dangerous at my age?
• I was hospitalized with severe chest and back pain and have been told that my descending aorta is dissected. I did not have surgery. Will I need it some day?
• My aneurysm was found first on an echocardiogram, and then a CT Scan was done. Later I had an MRI to check the size of the aneurysm. Why did I have three different kinds of tests?
• I have a chronic descending aortic dissection. I have been scheduled to have an exercise stress test. I am worried about the effect that a stress test may have on my aorta. Is it safe?
• I have heard that stents are now being used to repair the aorta in the chest. I have an enlarged descending aorta (4.8 cm) with a chronic dissection. Could a stent be considered to repair this?

• I have been told I have a bicuspid aortic valve. I also have an ascending aortic aneurysm. Did my valve cause this aneurysm?
• My bicuspid aortic valve was replaced five years ago. With the defective valve gone, am I protected from getting an aortic aneurysm?
• I had coarctation of the aorta repaired as a child. I have recently been diagnosed with an ascending aortic aneurysm of 4.6 cm. My aortic valve is also bicuspid. Did the coarctation cause this problem I have now? Are there special considerations for someone like me regarding aortic surgery?
• I understand that those with bicuspid aortic valves may also be at risk of dissection or aneurysm in the ascending aorta. I have been told that my bicuspid aortic valve must be replaced. My aorta is slightly enlarged. Are there any tests to see if my aorta is healthy or not? Should my aorta be replaced at the same time, or should it just be monitored, hoping that it will not enlarge further?
• My father and uncle both have bicuspid aortic valves and enlarged aortas. I have just been told that I have a bicuspid valve. If I have children some day, will they also have this condition?

• I have Marfan syndrome, and recently my ascending aorta was 3.9 cm when measured. I am being treated with a beta blocker. How often should my aorta be checked? What is the guideline for surgical replacement of the ascending aorta in a Marfan patient?
• I have Marfan syndrome and have had several surgeries to correct problems with my ankles and chest. About three years ago I experienced descending aortic dissection, for which I was hospitalized. At first surgery was planned, but it was not done. The descending aorta has enlarged and is now about 4.5 cm. My ascending aorta is not enlarged. Do I need surgery on my descending aorta?
• I have been evaluated for Marfan syndrome and told that I do not have it, but that I am "Marfan-like" in some ways. I am quite tall, have very flexible joints and was very athletic in school. Recently I have felt pressure and some pain in my chest, and a CT scan showed my ascending aorta is enlarged to 4.0 cm. I was told that I should have a CT scan again in 6 months. Should I accept this pressure and pain in my chest until then?
• I am a 35-year-old woman who has Marfan syndrome. Recently I began to experience chest pain when I do things like walking upstairs or doing household tasks, such as vacuuming. My primary care physician thinks this may be angina and suggested a nuclear medicine test to check on my coronary arteries. I do not have high cholesterol or other risk factors for coronary artery disease. Could this pain be from my aorta, which is enlarged to about 3.8 cm?
• I have been told that I will soon need surgery to replace my aortic valve and enlarged ascending aorta. Even though my arch and descending aorta are not enlarged, is it possible to replace my entire aorta with the same surgery so that I will not need any more aortic surgery in the future?
• I have lost several family members due to aortic dissection or aortic aneurysms related to Marfan syndrome. My own aorta is beginning to enlarge and is currently about 4.0 cm. I have read that aortic aneurysm surgery is performed when the aorta is at 5.0 cm. I have also read that surgery is done when the aorta has doubled in size. I am worried because my family members died before their aortas reached that size. Is it possible for me to safely have my aortic surgery done before it reaches these size guidelines?

• I have been told that I may have the Bentall procedure done during my aortic surgery. What is this procedure?
• During my aortic aneurysm surgery, the elephant trunk procedure was used. What is this?
• I was told that during surgery on my aortic arch my body temperature was very cold. Why was this done?
• What is the purpose of the breathing exercises that I will need to do following my surgery?
• I have been told that I have an ascending aneurysm and that I should consider surgery soon. I have no symptoms, and it is difficult for me to set the date for the surgery. What should the decision to have elective surgery be based on?
• I have an ascending aortic aneurysm and a bicuspid aortic valve. I have been told that I should have surgery when my aneurysm reaches 6.0 cm in diameter. Another opinion said it should be done at 5.5 cm. I know someone who had surgery at 4.4 cm. I am confused and wonder at what size surgery should be considered?
• I am 35 years old and will soon have surgery to replace my leaking bicuspid aortic valve and dilated ascending aorta. I have a friend who has a mechanical valve and takes Coumadin®. I do not want to take Coumadin, but I have heard that a tissue valve does not last very long. What are the trade offs in making this decision?