non-invasive aneurysm surgery, or open heart operation?

Question

i have found out that I have a heart aneurysm. I am trying to decide between non-invasive surgery and open heart surgery. I am 27 so I (hopefully!!!) have a long time ahead of me. I dont want to be in and out of surgery. does anyone know the chances of having to repeat surgery with the non-invasive methods, coil and stent and the risks of open heart surgery on someone my age. i think there is obviously less risk for me than for a 60 year old man.

Answer 1

you really should be talking to your doctor rather than letting people on yahoo answers influence your decision... i wouldnt even read any of the answers if it were me so they dont influence my judgement

Answer 2

Just a small addition.

I work in the operating room, recovery and in ICU as an RN.
Just to add another dimension: we do endoluminal aneursym repair and open repair at my facility.
What I have noticed it that the endoluminal repair patients have a mush faster, less painful and simpler recovery than the open repairs. This, of course, depends on the patient's health status.
We have not had an 'incident' with any patients that have had endoluminal repair in the 2 years I have been working there. These patients had been deemed stable and fit enough for this surgery and had been screened to ensure this procedure was appropriate for the type of aneursym repair required.

Goodluck
I agree - this is something that you need to discuss with your doctor rather than asking us!
PS: if you smoke - give up NOW

Answer 3

I do not think a heart aneurysm can be repaired by non invasive surgery. At your age open heart surgery is the best way.
For detail try URL below. Coil and stent can be used in aortic but not in heart aneurysm

Answer 4

Your question is of practical nature and a practical answer is required, which is as follows:
1) Aneurysm is a critical disease and requires an open field for surgeon to weigh the pros and crones as to the status of aneurysm, mere fiddling with it is not recommended.
2) Open heart surgery will give the surgeon a better chance of treating the aneurysm, as he can modify the technique if situation demands.
So kindly speak to your consulting surgeon.

Answer 5

Despite some on this forum not having the background to field questions, I think I might be able to help. Having said that, I am not a cardiothoracic surgeon, but I do have background in cardiology. Here's some information that I was able to find on your behalf.

NON-INVASIVE CLOSURE - DEVICE
Device closure may now be offered as an alternative to surgical closure to patients with secundum ASD of up to 36-38 mm in diameter. Early and intermediate follow-up is excellent after device closure. The intermediate results are comparable to surgery with a high rate of shunt closure and few major complications. Long-term outcome is unknown. Longer follow-up is needed to determine the incidence of arrhythmias and thromboembolic complications late after device closure.

Functional capacity improves and supraventricular arrhythmias are better tolerated and more responsive to pharmacologic management.

SURGICAL CLOSURE

For secundum ASD without pulmonary hypertension surgical closure should result in a very low (< 1%) operative mortality. Early and long-term follow-up is excellent.

Following surgical repair, pre-operative symptoms, if any, should decrease or abate. Pre-existing atrial flutter and fibrillation may persist unless cryo- or radiofrequency ablation (for the former) or a right atrial maze including pulmonary vein encirclement (for the latter) has been performed. Likewise, atrial flutter and/or fibrillation may arise de novo after repair, but are better tolerated and often more responsive to antiarrhythmic therapy.

Left ventricular failure may occur in patients with associated cardiovascular disease (e.g. coronary artery disease, hypertension, mitral valve incompetence).
Came from the web site of Adult Congenital Heart Disorder Association.
http://www.achaheart.org/resource/icon_cheartdefects.php

Further here is a journal article that supports transcatheter closure.
Clinical Research in Cardiology. 2/26/2007
Transcatheter closure of secundum atrial septal defects in adults with the Amplatzer septal occluder: Intermediate and long-term results.
CONCLUSIONS : More than 80% of adults with a distinct, hemodynamically significant secundum ASD can be successfully treated with the ASO. The immediate success rates are excellent and follow-up data suggest that the ASO is a safe device well suited for transcatheter ASD closure.

Here's another more relavent to over 40 year olds.
Journal of Interventional Cardiology. 2/20/2007
Transcatheter closure of atrial septal defects in adults > or =40 years of age: immediate and follow-up results.
CONCLUSIONS: ASD closure is safe and effective in patients over 40 years of age with minimal complications. The procedure resulted in a decrease in the RV size that was accompanied by improvement in clinical symptoms. Our findings suggest that device closure of ASDs in adult patients >40 years of age should be the first option of management.

There seem to be some good data to support the use of transcatheter repair. These repairs do lack the data to know what, if any, long term complications there might be, but short term and intermediate term look good.

Having an open heart surgery is a very big deal...probably one of the biggest surgeries you can have. Though mortality rate is low (< 1%) it still will take some getting over. The one article did mention that open heart surgery was the one of choice if there are other procedures they intend to do...and at your age, I am sure that is almost certainly not the case.

Discuss these issues with your cardiothoracic surgeon. Ask him if you were his neice, which procedure would he recommend for you. That question cuts through a lot of information and it will tell you the right answer. Good luck.