Thoracic aortic aneurysm

Alternative Names

Treatment

The treatment depends on the location of the aneurysm.

For patients with aneurysms of the ascending aorta or aortic arch, surgery to replace the aorta is recommended if the aneurysm is larger than 5-6 centimeters. The aorta is replaced with a fabric substitute. This is major surgery that requires a heart-lung machine. If the aortic arch is involved, a specialized technique called "circulatory arrest" -- a period without blood circulation while on life support -- may be necessary.

There are two options for patients with aneurysms of the descending thoracic aorta. If the aneurysm is larger than 6 centimeters, major surgery is done to replace the aorta with a fabric substitute.

Endovascular stenting is a less invasive option. A stent is a tiny metal or plastic tube that is used to hold an artery open. Stents can be placed into the body without cutting the chest. Instead, tiny, hollow tubes called catheters are inserted into the groin area. The stent is passed through the catheter and into the area of the aneurysm. Not all patients with descending thoracic aneurysms are candidates for stenting, however.

Outlook (Prognosis)

The long-term prognosis for patients with thoracic aortic aneurysm is determined by other medical problems such as heart disease and diabetes, which may have caused or contributed to the condition.

Possible Complications

Serious complications after aortic surgery can include heart attack, irregular heartbeats, bleeding, stroke, paralysis, graft infection, and kidney damage. Death soon after the operation occurs in 5-10% of patients.

Complications after aneurysm stenting include damage to the leg, which might require another operation.

When to Contact a Medical Professional

Patients with chest or back discomfort should consult their physician. Patients with a family history of connective tissue disorders should notify their physician.