Thoracic Aortic Aneurysm

Thoracic aortic aneurysms (TAA) affect approximately 15,000 people in the United States each year. Some patients may have more than one TAA or may also have an aneurysm in the abdominal aorta. Only about twenty to thirty percent of patients who get to the hospital with a ruptured TAA survive. For this reason, it is crucial to treat large aneurysms early, in order to prevent their rupture.

What is thoracic aortic aneurysm?

The aorta is the largest artery in the body, and it carries blood away from the heart to all the parts of the body. The part of the aorta that runs through the chest is called the thoracic aorta. When a weak area of the thoracic aorta expands or bulges, it is called a thoracic aortic aneurysm.

What is aortic dissection?

An aortic dissection occurs when blood flow forces the layers of the wall of the aorta apart, which weakens the aorta. The separation can extend from your thoracic aorta through the entire aorta and block arteries to the legs, arms, kidneys, bowel, brain, spinal cord, and other areas. Another problem associated with aortic dissection is that, over time, the pressure of blood flow can cause the weakened area of your aorta to bulge and form an aneurysm.

What is thoracic aortic trauma?

Severe blunt injury to the chest can cause traumatic aortic injuries. Patients suffering such an injury require urgent medical care. Thoracic aortic trauma is mostly lethal with only a small percentage of patients reaching the hospital. All of these injuries require urgent diagnosis and prompt management.

Symptoms

No Symptoms

Very few patients with thoracic aortic aneurysms notice symptoms.

Diagnosis

Examination

A complete physical examination and history.

Chest X-Ray

A chest x-ray can identify and locate thoracic aortic aneurysms, aortic dissections, and the presence of thoracic aortic trauma.

Echocardiography

An ultrasound of the heart can reveal the extent of your TAA.

Magnetic Resonance Imaging (MRI)

Performing an MRI can help to diagnose the scope of thoracic aortic aneurysms.

Computed Tomography (CT) Scan

This test assists with diagnosis and can reveal the extent of TAAs, thoracic aortic trauma, and aortic dissections.

Angiography

An angiogram can help your provider understand the impact of your TAA on your heart.

Intravascular Ultrasound (IVUS)

IVUS affords a view from inside the blood vessels, providing a clearer view of plaque buildup on the artery walls.

Treatments

During open aneurysm repair, an incision is made in the chest and the diseased part of the aorta is replaced with a synthetic graft. The graft is stronger than the weakened aorta and allows blood to pass through it without causing a bulge.

Endovascular means that the treatment is performed inside your body using long, thin tubes called catheters. The catheters are inserted in small incisions in the groin and are guided through the blood vessels. During the procedure, the surgeon will use live x-ray pictures viewed on a video screen to guide a stent-graft to the site of the aneurysm. The stent-graft allows blood to flow through the aorta without putting pressure on the damaged wall of the aneurysm. This keeps the aneurysm from rupturing.

Over time, the aneurysm usually will shrink. Endovascular stent-graft repair requires a shorter recovery time than open aneurysm repair, and the hospital stay is reduced to two or three days.

Endovascular repair of thoracic aortic pathology including both aneurysms and dissections are now used extensively. It is considered the standard of care for thoracic aortic aneurysm disease and thoracic aortic trauma.

Risks of Operation

Thoracic aortic aneurysm treatments carry a number of risks, including bleeding and infection, small myocardial infarction, risk of paraplegia, very small risk of stroke, and a very small risk of death.