Thoracic aortic aneurysms (TAA) can develop in the upper part of the aorta that runs through the chest cavity. Smoking, high blood pressure and family history are among the risk factors for the development of this condition. The risk of developing a TAA increases with age. Patients who have suffered an aortic dissection (a tear in the aorta) can also develop TAA. Men are more likely than women to experience this condition. Some genetic disorders of the connective tissue such as Marfan syndrome or Ehlers-Danlos syndrome may greatly increase the likelihood of developing a TAA.
Signs & Symptoms | Screening & Diagnosis | Treatment Options
Signs and Symptoms
TAA often results in few, if any, noticeable symptoms. Possible indications that you have this condition include:
- Chest or back pain
- Pain in the jaw, neck and upper back
- Hoarseness or coughing
- Difficulty catching your breath
Untreated thoracic aortic aneurysms could lead to congestive heart failure or a fatal rupture. If you suddenly experience these symptoms, seek immediate medical attention.
Screening and Diagnosis
At NorthShore, our vascular specialists ely on their vast clinical knowledge to accurately screen and diagnose patients with thoracic aortic aneurysms and employ the latest imaging tools when necessary. During your comprehensive evaluation, one of our experienced board-certified vascular surgeons will ask you about your medical history and conduct a physical exam.
Your physician expert may order one or several diagnostic tests, including a chest x-ray, echocardiogram (an ultrasound of the heart), magnetic resonance imaging (MRI) scan, computed tomography (CT) scan and angiography.
The size and location of your thoracic aortic aneurysm as well as your age and overall health will indicate the best treatment. At NorthShore, we recommend several treatment options depending on how fast and/or how large your aneurysm is growing.
- Watchful Waiting—Aneurysms measuring about 1.6 inches (or 4 centimeters) are considered small. Active surveillance is typically recommended as the risks of surgery may be greater than “watchful waiting.” Every six to 12 months, your NorthShore physician expert will monitor your aneurysm for changes in size using CT scans or ultrasounds. Aneurysms don’t disappear on their own. We strongly encourage regular follow-up appointments with your vascular surgeon. For patients with high blood pressure, medication to lower overall blood pressure may be prescribed to reduce the forces on the area where the aneurysm has developed.
- Minimally Invasive Endovascular Repair (TEVAR procedure)—Medium to large (2 inches or 5.0 centimeters and larger), thoracic aortic aneurysms or aneurysms that are rapidly growing or leaking will require surgical repair. Depending on the shape and location of your TAA, your NorthShore physician may recommend a TEVAR (thoracic endovascular repair) procedure for your aneurysm.
Performed in a specialized operating room with cutting-edge imaging capabilities, this innovative technique involves threading long thin tubes, or catheters, via small incisions made in the groin area, to place flexible synthetic tube-like devices called stent grafts (also known as an endografts) across the diseased aorta. These stent grafts work to essentially eliminate the aneurysm from the bloodstream. A less invasive procedure, endovascular stent graft placement features shorter hospital stays of 2 to 3 days and faster recovery when compared to open surgery.
- Open Surgery—Some TAAs can only be repaired via open surgery. The procedure involves making an incision in your chest to gain access to the damaged area of your thoracic aorta. These complex operations require a multidisciplinary approach combining the expertise of a vascular surgeon and a cardiac surgeon. Your NorthShore surgical team will use an artificial or synthetic graft to replace the weakened portion of your aorta. Hospital stays for open chest surgery typically range from 7 to 10 days and complete recovery may take from 6 weeks up to 3 months.
For More Information
Please call 847.663.8050 for more information on thoracic aortic aneuryms or to schedule an appointment with one of our vascular specialists.