Thoracoabdominal Aortic Aneurysm

Aneurysm affecting chest and abdomen a serious condition

The aorta, the largest blood vessel in the body, extends from the chest down to the abdomen. A weakening in the aorta can cause an aneurysm (bulging or dilation) which makes it difficult for the valve between the heart and the aorta to close properly. Aneurysm involving both the chest (thoracic) and abdominal aorta is a particularly serious condition usually requiring surgery.

Symptoms of thoracoabdominal aortic aneurysm are easy to miss

Aortic aneurysms are usually slow growing and you may not have any symptoms at all. The larger the size of the aneurysm, however, the greater the risk of rupture. Thoracoabdominal aortic aneurysms are often diagnosed during a CT scan or diagnostic test for some other medical condition. If you are experiencing symptoms such as pain in your chest, back or abdomen, or you have a genetic condition or family history of aortic disease, you may want to discuss your concerns with your doctor.

Treating thoracoabdominal aortic aneurysm

The main risk of thoracoabdominal aortic aneurysm is rupture, which can lead to massive internal bleeding and fatality. The aim of treatment is usually to relieve blood pressure on the aorta. This can be done with medication or with minimally invasive or open surgical techniques. In cases where the aneurysm is relatively small, ongoing monitoring (regular CT scans, ultrasound) and medication may be sufficient.


Descending Aortic Replacement

Open surgical repair is recommended for patients with aneurismal dilatation of the descending thoracic aorta (diameter of the descending aorta exceeding 5.5 cm) from chronic dissection, particularly if the aneurismal dilatation is associated with a connective tissue disorder.

Ascending Aortic Replacement

Ascending aorta replacement is performed when there is aneurismal enlargement or dissection of the aortic root. The ascending aorta is very often involved in this process, and it is replaced at the same time as the aortic root.

Aortic Root Replacement

With an aortic root repair or replacement surgery, the aortic root is replaced with a composite valve graft, which is a mechanical or biological valve attached to a synthetic artificial tube. There are a variety of mechanical valves to choose from that would attach to the synthetic tubes.

Aortic Valve Repair

A technique that allows cardiovascular surgeons to repair the aortic valve and replace the enlarged ascending aorta from the sinotubular jugular to the arch is called the David procedure and is routinely performed at Lankenau Heart Institute. Learn more about aortic valve repair.

Valve-Sparing Aortic Root Surgery

During this operation, the aortic sinuses are removed, and the aortic valve commissures with the leaflets are reimplanted inside a synthetic tube graft.

Surgical Aortic Valve Replacement (SAVR)

For more than 50 years, surgical aortic valve replacement (SAVR) has been the standard treatment for severe symptomatic aortic stenosis and for aortic regurgitation.

Endovascular Aortic and Hybrid Procedures

Endovascular repair (also called endovascular stenting) is one of the most recent advancements in aortic surgery. It is used in patients whose anatomy is "favorable"—that is, their aneurysms or dissections do not span any major arteries.