An aneurysm is a blood vessel dilation. Aorta is the largest blood vessel in your body. When the aortic wall weakens and bulges it is called aortic aneurysm. Normally the aorta measures about 1.5-2.0 cm in diameter. If the the vessel diameter measures about more than 3.5 cm it is called aneurysm.
There are two locations of aortic aneurysms. Thoracic aortic aneurysm is located in the chest and Abdominal aortic aneurysm is located in the abdomen. In this chapter we will focus on thoracic aortic aneurysm. You can get more information for abdominal aortic aneurysms under the vascular disease section.
Risk Factors for Aortic Aneurysm
- Family History
- High Blood Pressure
- High Cholesterol
Usually you wont have any symptoms at first. In fact many cases are first discovered during an examination for another condition. Depending on the location of the aneurysm, it might press against nearby tissues and patients may notice steady pain in the back. Patients may feel coughing, hoarseness, difficulty breathing or swallowing.
- The major complication of the aortic aneurysm is rupture or dissection. This will cause internal bleeding and patients may feel sudden severe pain in the chest, loss of consciousness and breathless.
A Thoracic aortic aneurysm can diagnosed with echocardiogram and computed tomography. Using these tests we can determine the best treatment option for you. If the diameter is more than 5-5.5 cm or is expanding ( 0.5 cm / 6 months ) you may require surgery.
Open surgical repair is the gold standard method for most thoracic aortic aneurysms. The aneurysmatic part of the aorta is replaced with a prosthetic tube graft. In order to replace the aneurysmatic part the patient is placed on heart lung machine and the machine does the job of the heart and lungs during the operation. The operation takes 4-6 hours and recovery takes about 2-3 weeks.
If the aneurysm is located at the descending thoracic aorta, a new technique called “Endovascular Aneurysm Repair” can be used. In this procedure an incision is made in the groin , then a fabric covered metal stent is inserted at the side of the aneurysm.
In extensive aortic aneurysms a hybrid procedure is used to shorten the operation.This new technique combines the open repair and endovascular repair.