Thoracic Aortic AneurysmSymptoms, Doctors, Treatments, Advances & More
Learn About Thoracic Aortic Aneurysm
An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel.
A thoracic aortic aneurysm occurs in the part of the body's largest artery (the aorta) that passes through the chest.
Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic
The most common cause of a thoracic aortic aneurysm is hardening of the arteries (atherosclerosis). This condition is more common in people with high cholesterol, long-term high blood pressure, or who smoke.
Other risk factors for a thoracic aneurysm include:
- Changes caused by age
- Connective tissue disorders such as Marfan or Ehlers-Danlos syndrome
- Inflammation of the aorta
- Injury from falls or motor vehicle accidents
- Syphilis
Aneurysms develop slowly over many years. Most people have no symptoms until the aneurysm begins to leak or expand.
Symptoms often begin suddenly when:
- The aneurysm grows quickly.
- The aneurysm tears open (called a rupture).
- Blood leaks along the wall of the aorta (aortic dissection).
If the aneurysm presses on nearby structures, the following symptoms may occur:
- Hoarseness
- Swallowing problems
- High-pitched breathing (stridor)
- Swelling in the neck
Other symptoms may include:
- Chest or upper back pain
- Clammy skin
- Nausea and vomiting
- Rapid heart rate
- Sense of impending doom
There is a risk that the aneurysm may open up (rupture) if you do not have surgery to repair it.
The treatment depends on the location of the aneurysm. The aorta is made of three parts:
- The first part moves upward toward the head. It is called the ascending aorta.
- The middle part is curved. It is called the aortic arch.
- The last part moves downward, toward the feet. It is called the descending aorta.
For people with aneurysms of the ascending aorta or aortic arch:
- Surgery to replace the aorta is recommended if an aneurysm is larger than 5 to 6 centimeters (approximately 2 inches).
- A cut is made in the middle of the breast bone (sternum).
- The aorta is replaced with a plastic or fabric graft.
- This is major surgery that requires a heart-lung machine.
For people with aneurysms of the descending thoracic aorta:
- Major surgery is done to replace the aorta with a fabric graft if the aneurysm is larger than 6 centimeters (2.3 inches).
- This surgery is done through a cut on the left side of the chest, which may reach to the abdomen.
- 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. However, not all people with descending thoracic aneurysms are candidates for stenting.
Baylor Medicine - Vascular Surgery
Dr. Gustavo Oderich focuses on the clinical evaluation, open surgical and endovascular treatment of aneurysms, dissections, trauma, and aortic pathology involving any segment of the aorta, including the aortoiliac, juxtarenal, pararenal, complex abdominal, thoracoabdominal and aortic arch.He has broad and extensive experience in a wide spectrum of arterial and venous diseases affecting all vascular beds, including carotid, supra-aortic trunk, upper and lower extremity, abdominal and pelvic vessels.He is a world-renowned authority on innovative minimally invasive endovascular techniques to treat complex aortic aneurysms using fenestrated and branched stent grafts. Dr. Oderich has several firsts, including the “first-in-man” implant of the antegrade WL Gore TAMBE stent-graft (Thoraco-Abdominal Multi-Branch Endoprosthesis), the first-in-man implant of the Cook ZFEN Plus stent-graft and the first-in-man total trans-femoral three vessel arch device using antegrade branches. Dr. Oderich extensive clinical experience includes thousands of patients treated by open surgical and endovascular procedures. He has performed over 2,000 standard endovascular and thoracic aortic repairs (EVARs/TEVARs) and nearly 900 fenestrated-branched, fenestrated and branched endovascular repairs (FB-EVAR, FEVAR, BEVAR).Dr. Oderich clinical experience as a leader in vascular surgery spans over two decades. He has a versatile open surgical and endovascular practice that also includes the management of carotid, supra-aortic trunk, renal, and mesenteric artery diseases. He is involved in the multidisciplinary care of patients with connective tissue or heritable disorders including Marfan’s, Loeys-Dietz Syndrome and Vascular Ehlers Danlos Syndrome. Dr. Oderich is rated as an Elite provider by MediFind in the treatment of Thoracic Aortic Aneurysm. His top areas of expertise are Thoracic Aortic Aneurysm, Abdominal Aortic Aneurysm (AAA), Aortic Dissection, Aneurysm Repair, and Stent Placement.
Baylor College Of Medicine - Cardiothoracic Surgery
Joseph Coselli is a Thoracic Surgeon in Houston, Texas. Dr. Coselli is rated as an Elite provider by MediFind in the treatment of Thoracic Aortic Aneurysm. His top areas of expertise are Thoracic Aortic Aneurysm, Aortic Dissection, Marfan Syndrome, Coronary Artery Bypass Graft (CABG), and Aortic Valve Replacement. Dr. Coselli is currently accepting new patients.
Beth Israel Deaconess Medical Center
Marc Schermerhorn is a Vascular Surgeon in Boston, Massachusetts. Dr. Schermerhorn is rated as an Elite provider by MediFind in the treatment of Thoracic Aortic Aneurysm. His top areas of expertise are Thoracic Aortic Aneurysm, Abdominal Aortic Aneurysm (AAA), Carotid Artery Disease, Aneurysm Repair, and Carotid Artery Surgery.
The long-term outlook for people with thoracic aortic aneurysm depends on other medical problems, such as heart disease, high blood pressure, and diabetes. These problems may have caused or contributed to the condition.
Serious complications after aortic surgery can include:
- Bleeding
- Graft infection
- Heart attack
- Irregular heartbeat
- Kidney damage
- Paralysis
- Stroke
Death soon after the operation occurs in 5% to 10% of people.
Complications after aneurysm stenting include damage to the blood vessels supplying the leg, which may require another operation.
Contact your health care provider if you have:
- A family history of connective tissue disorders (such as Marfan or Ehlers-Danlos syndrome)
- Chest or back discomfort
To prevent atherosclerosis:
- Control your blood pressure and blood lipid levels.
- DO NOT smoke.
- Eat a healthy diet.
- Exercise regularly.
Summary: the comparison of physician-modified stent-graft created in 3D models versus custom-made devices in the treatment of complex abdominal aortic aneurysm
Summary: The primary clinical objective of this study is to evaluate the safety and effectiveness of a physician-modified, fenestrated and branched aortic endoprosthesis for the treatment of thoracoabdominal aortic aneurysms (TAAAs). The goal of the primary analysis is to demonstrate both the safety and effectiveness of using a physician-modified fenestrated Cook Zenith Alpha Thoracic Endovascular Graft as...
Published Date: May 10, 2024
Published By: Neil Grossman, MD, Saint Vincent Radiological Associates, Framingham, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Singh MJ, Makaroun MS. Thoracic and thoracoabdominal aneurysms: endovascular treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 80.