Thoracic Aortic Aneurysm Repair
What is a thoracic aortic aneurysm?
The aorta is the largest blood vessel in the body that supplies the body with oxygenated blood. A thoracic aortic aneurysm is a weakened, bulging area that occurs in the aorta in the chest. An aneurysm gradually grows and gets progressively weaker. A thoracic aortic aneurysm may be caused by:
- A degenerative disease which may cause the breakdown of the tissue of the aortic wall
- Genetic disorders
- Family history
- Atherosclerosis
- An infection
- Inflammation of the arteries called vasculitis.
What are the symptoms of a thoracic aortic aneurysm?
Depending on the size of the aneurysm, the location, and how fast it is growing, a thoracic aortic aneurysm may cause symptoms such as:
- Pain in the jaw, neck, or upper back
- Pain in the chest or back
- Coughing, wheezing or shortness of breath which may be a result of pressure in the trachea, also called the windpipe.
- Hoarseness, which may be a result of pressure on the vocal cords
- Difficulties with swallowing which may be a result of pressure in the oesophagus
In most cases, a thoracic aortic aneurysm does not cause any symptoms until it ruptures or tears. When a rupture or tear occurs, seek immediate medical attention. When an aneurysm ruptures or the layers of the artery wall tears, the patient may experience symptoms such as:
- A sudden sharp pain in the upper back, which may radiate downwards
- Pains in the chest, jaw, neck, or arms
- Difficulty with breathing
What does thoracic aortic aneurysm repair involve?
Surgery is normally recommended for thoracic aortic aneurysms, when:
- The aneurysm is 5-6 centimetres or larger
- The patient has another connective tissue disease
- The patient has a bicuspid aortic valve
- The patient has a family history of aortic dissection
- The patient is at high risk of getting an aortic dissection
Depending on the condition and the location of the thoracic aortic aneurysm, endovascular surgery may be performed. The procedure is done under general anaesthetic. The procedure involves the insertion of a synthetic stent graft through an artery in the groin and passing through the aneurysm in the aorta. The graft is then placed at the site of the aneurysm and secured in place with the use of small hooks or pins. This prevents the aneurysm from rupturing. The artery in the groin is repaired and the wound closed with absorbable sutures.
After the procedure, the patient will be nursed in the High Care Unit, and most patients are discharged after 2 days. The patient will have follow-up appointments to help ensure that the graft is in a good position and working well.
