Thoracic aortic aneurysms are bulging, weakened areas in the wall of the aorta. They occur in the parts of the aorta that travel through the chest and into the abdomen. This area is called the descending thoracic and thoracoabdominal aorta.
At UPMC, cardiothoracic and vascular surgeons provide expert care for these types of aneurysms.
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The aorta — the largest artery in the body — carries all the blood that is pumped out of the heart. Thoracic aortic aneurysms are bulging, weakened areas in the wall of the aorta. They occur in the part of the aorta that runs from the aortic arch to the diaphragm, and the diaphragm to the abdomen.
Approximately 15,000 Americans are diagnosed with thoracic aneurysms (TAA) each year. Thoracoabdominal aortic aneurysms (TAAA) are less common.
There are two types of thoracic aortic aneurysms:
Aortic aneurysms occur because of tissue changes in the wall of the aorta. These changes sometimes cause the aorta to narrow or become blocked due to conditions like atherosclerosis, which causes plaque to build up inside the arteries. This can cause a breakdown of the muscular layer in the aorta, resulting in aneurysms.
Traumatic injury and aortic dissection are other conditions that can cause thoracic aortic aneurysm.
Risk factors for thoracic aortic aneurysms include:
TAAs and TAAAs are serious health risks because they can burst or rupture, causing severe internal bleeding that can rapidly lead to shock or death.
The larger the aneurysm, or the faster it grows, the more likely it is to rupture.
The risk of rupture increases when the aneurysm is larger than about twice the normal diameter of a healthy aorta.
You may not be able to control some of your aortic aneurysm risk factors. However, preventing heart disease and chronic conditions can reduce the risk that you will develop an aortic aneurysm. You may be able to reduce your risk of developing aortic aneurysm by:
Descending thoracic aortic aneurysms (TAAs) and thoracoabdominal aortic aneurysms (TAAAs) often go unnoticed, yet early diagnosis is critical to managing these conditions.
Only half of people with TAAs and TAAAs have symptoms, which may include:
Aortic aneurysms can cause life-threatening bleeding if they rupture. If you experience symptoms of an aortic rupture, you should dial 911.
If your doctor suspects a TAA or TAAA, you'll need to undergo a thorough physical exam and evaluation.
To diagnose a thoracic aortic aneurysm, your vascular surgeon will:
Following your exam, your doctor may order additional tests and procedures to help confirm the presence and size of the thoracic aneurysm. These diagnostic tests may include:
Your prognosis after diagnosis with a thoracic aortic aneurysm depends on the size and extent of your aneurysm. Aortic aneurysm rupture, for example, is a serious, life-threatening condition with a low survival rate. However, if your aneurysm has not ruptured, your doctor may be able to provide surgical treatment that reduces the risk of aortic rupture.
UPMC offers a full range of state-of-the-art aneurysm treatment options for TAAs and TAAAs. Aneurysm treatment depends on its size and location and your overall health.
If your aneurysm is small and does not cause symptoms, your doctor may recommend monitoring your condition. Surgeons consider aneurysm repair surgery when the TAA or TAAA becomes large.
Thoracic aortic aneurysms grow at different rates depending on the size of the aneurysm and where it is located. Because the risk of rupture increases as your aneurysm grows, your doctor will monitor your aneurysm closely to reduce your risk of rupture.
If your aneurysm is six centimeters in diameter or more, your doctor may recommend surgery. During open thoracic aortic aneurysm repair, your surgeon will:
After surgery, you will stay in the hospital for 5-7 days. Most patients make a complete recovery in 2-3 months, depending on the complexity of your surgery, your overall health, and whether you have other conditions such as heart, lung, or kidney disease.
Your surgeon may recommend repairing your thoracic aortic aneurysms with a minimally invasive EVAR procedure. Whether or not you can have EVAR procedure depends on the shape, location, and extent of the aneurysm.
In contrast to a traditional “open" surgery, no big incisions are made in the chest. Instead, the arteries in the groin are accessed either by a needle puncture or a small incision.
During EVAR, your doctor will:
After an EVAR, most people recover quickly and can often go home the next day. However, because the stent can shift over time, yearly follow-ups with your surgeon are required.
EVAR reduces your hospital stay by 2-3 days and requires less recovery time when compared to traditional open thoracic aortic aneurysm repair.
If EVAR is not an option for you, you may have access to other minimally invasive treatment options. UPMC routinely participates in clinical trials of leading-edge devices to treat complex aortic aneurysms.
Many open aneurysm repairs are successful in the long term with few complications. Follow-up after open aneurysm repair is less frequent than that for EVAR, with most patients coming back every 2-3 years for a checkup.
However, EVAR requires more frequent follow-up visits and imaging studies to ensure that the graft continues to function properly. You also may require periodic maintenance procedures.
Your life expectancy depends on whether you receive early, effective treatment, the size and extent of your aneurysm, and whether your aneurysm has ruptured. Your doctor will discuss your life expectancy with you.
At UPMC, you have immediate access to state-of-the-art diagnostic and treatment options for thoracic aortic aneurysm. When you choose UPMC, you will benefit from:
Last reviewed by a UPMC medical professional on 2024-10-01.
