Thoracic Aortic Aneurysm

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Why Choose UVA for Thoracic Aortic Aneurysm Treatment?

At UVA, our cardiovascular surgeons are trained in both cardiac and vascular surgery to most effectively treat thoracic aortic aneurysms and thoracic aortic dissections.

UVA was the first medical center in the state of Virginia to use stent-graft technology to treat thoracic aortic aneurysms. Additionally, our genetics program evaluates patients with aortic pathologies and connective tissue disorders and screen their at-risk family members.

Aortic and vascular surgical achievements at UVA include: 

  • The region’s most extensive experience in aortic dissection treatment, thoracoabdominal aneurysms and connective tissue disorders
  • Developing treatments such as hybrid thoracoabdominal and arch aneurysm repairs, which combine open and endovascular procedures
  • Being the first hospital in Virginia to perform FDA-approved thoracic endovascular aortic aneurysm repair (TEVAR)
  • Low rates of mortality and morbidity for both elective and emergency procedures when compared to STS averages

What is a Thoracic Aortic Aneurysm?

A thoracic aortic aneurysm (TAA) is a bulging and weakness in the wall of the aorta, the largest blood vessel in the body, located in the chest. The aorta delivers blood from the heart to the rest of the body.

There are three sections of the aorta in the chest:

  • The ascending thoracic aorta, which extends up from the top of the heart's left ventricle 
  • The aortic arch, where the artery turns towards the back and curls
  • The descending thoracic aorta, located at the back of the chest cavity

An aneurysm can occur in any of the three areas. A thoracic aortic aneurysm can burst, which can cause life-threatening, uncontrolled bleeding.

Causes of Thoracic Aortic Aneurysms

Factors that may cause TAA include:

  • Atherosclerosis
  • Congenital weakness of artery wall
  • Weakness of artery wall from smoking or high blood pressure 
  • Tearing of artery wall
  • Trauma
  • Family history of TAAs 

Are You at Risk?

aortic arch aneurysm

Risk factors vary depending on the type of aneurysm, though atherosclerosis is a key risk factor for all three types of TAAs. 

Descending thoracic aneurysm risks include:

  • Age 60 or older
  • Male gender
  • Family history of TAA
  • High cholesterol
  • High blood pressure
  • Smoking
  • Diabetes
  • Genetic disorders

Aortic arch thoracic aneurysm risks include:

  • Takayasu's arteritis
  • Continuation of an ascending or descending thoracic aneurysm

Ascending thoracic aneurysm risks include:

  • Cystic medial degeneration (tissue breakdown in the aortic wall)
  • Genetic disorders (such as Marfan syndrome, Ehlers-Danlos syndrome, Turner's syndrome and polycystic kidney disease) that affect connective tissue such as bones, cartilage and blood vessels
  • Family history of TAA

Symptoms of TAA

Most thoracic aortic aneurysms develop slowly over time and can remain asymptomatic until they leak or rupture. Many times, your healthcare provider finds TAA when you undergo a CT scan for other reasons.

When a thoracic aneurysm ruptures, you often experience excruciating chest or back pain. You may have difficulty breathing or lose consciousness. Rarely, some aneurysms grow large enough to put pressure on certain nerves, or the airway or food pipe. This can cause hoarseness, wheezing or difficulty swallowing.

How We Diagnose TAA

Our specialists can diagnose you through a variety of exams, including:

  • Chest X-ray
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Angiography
  • Echocardiography

Treatment for A Thoracic Aortic Aneurysm

It's important to treat aneurysms before they rupture. Once a thoracic aneurysm ruptures chances of survival fall to 50 percent. However, when patients are treated electively before the aneurysm ruptures, chances of survival are greater than 90 percent.

Treatment options include:

  • Close monitoring: Regular screenings to check the size and growth of the aneurysm to determine if treatment is necessary
  • Lifestyle changes: Steps such as quitting smoking, controlling diabetes and eating a low-fat diet to reduce cholesterol may help keep the aneurysm from growing
  • Medication: Medicine to reduce cholesterol or high blood pressure
  • Surgery: Surgeons may repair the aneurysm with a stent graft, they insert into the aorta through an artery in the leg. You may need open surgery (requiring a larger incision in your chest) to repair the aneurysm by replacing it with an artificial blood vessel.

 

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.