Thoracic Aortic Aneurysm

The aorta is usually 2-8-4.5cm in width depending on age and weight. When the aorta swells it can grow to 1.5 times the size. This is diagnosed as an aortic aneurysm. Aneurysms are usually slow-growing but some can be fast-growing. It is important to be diagnosed and treated for aneurysms because if they tear or rupture, they can cause internal bleeding.

What causes an aortic aneurysm?

The aorta is constantly pumping blood from the heart, this causes the aorta to be under a lot of pressure. The aorta needs to be flexible to return to shape after a pulse of blood has pumped through. Sometimes the walls become weak and less flexible that can be due to plaque (atherosclerosis) and the additional pressure can cause the aorta to bulge and form an aneurysm. 
An aneurysm in the aorta can form at any part of the vessel, from your thoracic to your abdomen.

Family history and genetics can also be a factor of cause for thoracic aortic aneurysm. Other risk factors can include, high blood pressure and cholesterol, smoking and infection and trauma.

Signs and symptoms

Thoracic aortic aneurysms often do not accompany with any symptoms because they are slow growing. They are usually found by accident during unrelated diagnostic tests and screenings for other medical conditions. Although it is unusual to have any symptoms, some may occur:

• Shortness of breath
• Feeling cold, sweaty or clammy
• Severe chest or back pain
• Cough
• Hoarseness

If you are experiencing some of these symptoms or have severe chest pain and difficulty breathing it is important to call 999.

Diagnostic and treatment

An aneurysm can be detected from tests like x-ray, CT scanning and ultrasound. MRI scans and echocardiogram are also used for diagnosing aneurysms.

The main goal is to prevent your aneurysm from growing bigger. If it is a slow growing aneurysm then the ‘watch and wait’ method will be recommended. Your doctor will discuss some lifestyle changes and medication like beta blockers and statins before surgical intervention is considered. Regular scans will be applicable with follow up consultations to discuss how the patient is getting on and if there is any change to the aneurysm. Of course, this all depends on the severity and symptoms of the patient.

 Surgery for a thoracic aortic aneurysm will be recommended if it is too large to monitor and poses a risk of rupturing. The surgery can be open-chest or endovascular.

Open chest

A large incision will be made over the chest area. The damaged part of the aorta will be replaced with a graft and sewn in to place. Open chest surgery does accompany more risks like infection and bleeding and there is also a long recovery time.

Endovascular surgery

A large incision is not needed for this procedure. A small incision will be made in your groin area, a long thin tube called a catheter with a synthetic graft at the end will be inserted through an artery and up towards the aneurysm. The graft will be placed and fixed at the aneurysm site and will reinforce the weakened aorta. This will prevent a rupture. There are a lot less risks with this procedure and the recovery time is quicker and less painful. Regular follow ups will need to be done to ensure the graft is not malfunctioning.