Sunday, January 31, 2010

Thoracic Aortic Aneurysm


A thoracic aortic aneurysm is the widening of the wall of the aorta. When there is a weakening in the wall of the aorta it causes swelling. Most thoracic aneurysms develop in the descending aorta. Arthersclerosis seems to be the cause of a thoracic aortic aneurysm. Long term high blood pressure, trauma, history of Marfan's syndrome and syphilis are also risk factors associated with aortic aneurysms. Most patients do not have any symptoms until the aneurysm begins to leak. A good indicator of that would be chest or back pain. Most thoracic aortic aneurysms are found incidentally. Especially if they have not presented with any of the symptoms. A chest x-ray and more importantly a CT scan can show enlargement of the aorta. A CT scan specifically determines the exact location and size of the aneurysm. An aortogram may also be utilized to determine all areas of the aorta affected. If the aortic aneurysm is in the aortic arch and is larger than 5-6 centimeters then the aorta should be replaced with a fabric substitute. This is a more risky surgery because the patient will need to be placed on a heart-lung bypass machine. This prevents blood flow during the surgery. If the patient presents with an aneurysm in the descending aorta they will have to have it replaced with fabric substitute if it is larger than 6 centimeters. The second option for descending thoracic aortic aneurysms is endovascular stenting. This stent is placed through the groin and is placed at the site of the aneurysm to help keep the aorta open. This procedure is less invasive for the patient. The prognosis is highly determined by the patients history. Their prognosis determines how many risk factors contributed to the aortic aneurysm.