The aorta is the largest blood vessel in the body. It delivers oxygen-rich blood from the heart to the rest of the body. “Thoracic” refers to the part of the aorta that runs through the chest (thorax).
An aortic aneurysm is a weakened area in the wall of the aorta that can bulge outward. Once formed, an aneurysm will gradually increase in size and the wall of the aorta will get progressively weaker, putting it at risk of bursting (rupture) or separating (dissection). This is a medical emergency that can cause life-threatening bleeding and potentially death.
While it is possible to surgically repair a ruptured thoracic aortic aneurysm on an emergency basis, the risk is much greater. That’s why doctors strive to detect and treat thoracic aortic aneurysms before they rupture, with close monitoring and preventive surgery.
The vascular and endovascular surgeons at Cooper University Health Care are highly qualified to diagnose and treat thoracic aortic aneurysms, performing both open surgery and minimally invasive endovascular techniques when intervention is appropriate.
Why Choose Cooper to Treat Thoracic Aortic Aneurysm
Cooper is a high-volume center for aneurysm repair procedures. This means our surgeons have a depth of experience that helps ensure excellent outcomes for our patients.
In addition, Cooper’s surgeons are on the forefront of thoracic endovascular aortic repair (TEVAR), having studied this advanced procedure in clinical trials. As a result, we are one of the most experienced centers in the nation when it comes to this innovative minimally invasive approach—a level of expertise few hospitals can match.
Risk Factors for Thoracic Aortic Aneurysm
Factors that can increase your risk of or contribute to the development of a TAA include:
- Atherosclerosis (buildup of plaque in the arteries)
- High blood pressure
- Genetic disorders, such as Marfan, Ehlers-Danlos and Loeys-Dietz syndromes, that affect the connective tissue of the aortic wall
- Family history of TAA
- Tobacco use
- Aortic valve problems
- Inflammation of the arteries (vasculitis or arteritis)
- Infection (rare)
Thoracic Aortic Aneurysm Symptoms
Thoracic aortic aneurysms often grow slowly and without symptoms, making them difficult to detect. When symptoms do occur, they may be related to the aneurysm’s location and size, and how fast it is growing. Some people may notice:
- Pain in the jaw, neck, chest or upper back
- Wheezing, coughing as a result of pressure on the trachea (windpipe)
- Shortness of breath
- Hoarseness as a result of pressure on the vocal cords
- Trouble swallowing due to pressure on the esophagus
Sudden, severe pain associated with a thoracic aneurysm may be a sign of a life-threatening rupture or dissection, a medical emergency. Call 9-1-1 immediately.
How Thoracic Aortic Aneurysm Is Diagnosed
Your doctor will do a complete medical history and physical exam, and order certain diagnostic tests which ma include:
- CT scan: This test uses X-rays and computer technology to create detailed images of the body
- Magnetic resonance imaging (MRI): This test uses magnets, radio waves, and a computer to produce detailed images of the body
- Echocardiogram: This ultrasound test evaluates the structure and function of the heart and its valves using sound waves
- Transesophageal echocardiogram (TEE): We perform this type of echocardiogram by inserting a specialized probe down the esophagus; this provides clear images of the thoracic aorta because the sound waves don’t have to pass through skin, muscle, or bone
- Arteriogram (angiogram): A special dye is injected into the blood vessels and an x-ray is taken, enabling your doctor to determine the size and location of an aneurysm
How Thoracic Aortic Aneurysm is Treated
Depending on the size and location of an aneurysm, and how fast it’s growing, treatment may include:
- Monitoring: A small aneurysm or one that doesn't cause symptoms may not require surgical treatment until it reaches a certain size or is growing rapidly. Your doctor may recommend "watchful waiting" with a CT or MRI scan every 6 months to monitor the aneurysm.
- Managing risk factors: Quitting smoking, controlling blood sugar if you have diabetes, losing weight if overweight, and eating a healthy diet may help control progression of an aneurysm
- Medication: May be used to control conditions such as high blood pressure or cholesterol
- Surgery (thoracic aortic aneurysm open repair): Surgery may be recommended when an aneurysm is a certain size and/or causes symptoms. The type of surgery depends on the location and type of aneurysm, and your overall health; it requires a large incision through the breastbone or side of the chest to access the thoracic aorta.
- Thoracic endovascular aneurysm repair (TEVAR): A minimally invasive alternative to open surgery in certain patients, TEVAR is performed using a long, thin tube (catheter) inserted through a tiny incision in the groin to deliver a stent-graft via blood vessels to the site of the aneurysm. The stent-graft relieves pressure on the damaged aortic wall by causing blood flow to bypass the aneurysm.