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Thoracic aortic aneurysm - Treatment

Alternative Names

Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic

Treatment:

The treatment depends on the location of the aneurysm. The aorta is made of three parts:

  • The first part moves upwards towards the head. It is called the ascending aorta.
  • The middle part is curved. It is called the aortic arch.
  • The last part moves downwards, toward the feet. It is called the descending aorta.

For patients with aneurysms of the ascending aorta or aortic arch:

  • Surgery to replace the aorta is recommended if an aneurysm is larger than 5 - 6 centimeters. The aorta is replaced with a plastic or fabric graft. This is major surgery that requires a heart-lung machine.

For patients with aneurysms of the descending thoracic aorta:

  • Majory surgery is done to replace the aorta with a fabric graft if the aneurysm is larger than 6 centimeters.
  • 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. Not all patients with descending thoracic aneurysms are candidates for stenting, however.

See also: Aortic aneurysm repair - endovascular

Expectations (prognosis):

The long-term prognosis for patients with thoracic aortic aneurysm is determined by other medical problems such as heart disease and diabetes, which may have caused or contributed to the condition.

Complications:

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 - 10% of patients.

Complications after aneurysm stenting include damage to the leg, which may require another operation.

Calling your health care provider:

Tell your doctor if you have:

  • A family history of connective tissue disorders
  • Chest or back discomfort
  • Reviewed last on: 6/2/2010
  • Shabir Bhimji MD, PhD, Specializing in Cardiothoracic and Vascular Surgery, Midland , TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Safi HJ, Estrera AL, Miller CC 3rd, Azizzadeh A, Porat EE. Thoracic vasculature with emphasis on the thoracic aorta. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 63.

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