A thoracic aortic aneurysm is a bulge in a weakened part of the aorta in the chest. The aorta is the major blood vessel carrying blood from the heart through the abdomen to the legs. Blood carried by the aorta supplies all parts of the body with oxygen and nutrients.
Much like an over-inflated balloon filled with water, a thoracic aortic aneurysm is at risk of rupturing if not diagnosed and repaired.
Thoracic aortic aneurysms are a serious health risk because they can burst or rupture. A ruptured aneurysm can cause severe internal bleeding, which can rapidly lead to shock and death. Thoracic aneurysms affect approximately 15,000 people in the United States each year. Only about 20 to 30 percent of patients who get to the hospital with a ruptured thoracic aneurysm survive.
If blood flow forces the layers of the wall of your aorta apart, the condition is called an aortic dissection.
Atherosclerosis is the most common cause of a thoracic aneurysm. Atherosclerosis occurs when the lining of your arteries deteriorate and thicken with plaque deposits and is commonly known as “hardening of the arteries”. Plaque is a build-up of cholesterol, fat, and calcium. Over time plaque narrows or stiffens your arteries. Normally, the walls of your hollow, tube-shaped arteries are smooth and elastic.
If the thoracic aortic aneurysm is small and not causing symptoms, your physician may recommend monitoring every 6 months for signs of changes using a CT or MRI scan. During this time good blood pressure control will reduce some of the pressure on the aneurysm. Activity restriction such as heavy lifting should be avoided to reduce the strain on the aorta.
Surgical treatment options:
- Invasive or open surgery
- Minimally invasive or endovascular surgery
During open aneurysm repair, your surgeon makes an incision in your chest and replaces the weakened portion of your aorta with a fabric tube, called a graft. Blood flows through the graft and protects the weakened aorta. This is considered the standard treatment for thoracic aortic aneurysms. Some aneurysms also involve the aortic valve and valve replacement may be needed at the same time.
A minimally invasive procedure is done using a graft mounted on a stent. The stent graft is threaded up the aorta and is expanded with a balloon to secure it in place. This reinforces the weakened aorta. It has been more recently developed.