Thoracic Aortic Aneurysm
Thoracic Aortic Aneurysm Care at UVM Health
The aorta is the largest blood vessel in the body, leading from the heart to the rest of the body. When a section of the aorta begins to weaken, the pressure of the blood flowing through the vessel causes it to expand or bulge. Aneurysms can develop anywhere along the aorta, but thoracic aortic aneurysms (TAA) are located in the chest area.
If an aneurysm ruptures and forms a tear in the wall of the aorta, it can cause life-threatening bleeding. If you have an aneurysm, it will require consistent monitoring to ensure it doesn’t grow. A range of surgeries and procedures are available to treat large, fast-growing or symptomatic aneurysms and prevent a rupture.
Why Choose UVM Health?
At University of Vermont Health, we take a coordinated, team-based approach to diagnosing and treating thoracic aortic aneurysms. Our network of heart and vascular providers gives you access to advanced surgeons, so no matter where you live in Vermont or northern New York, you can get personalized care that helps you live a full and healthy life.
As one of the leading heart and vascular programs in the region, we offer:
- Specialized experts: Our nationally accredited, non-invasive diagnostic laboratory at the UVM Center for Aortic Diseases brings together a multidisciplinary team of vascular and cardiothoracic surgeons to diagnose and treat complex aortic disease.
- Excellent outcomes: Our vascular and cardiothoracic surgery teams track our patient outcomes in national registries. Our outcomes consistently meet — or exceed — national benchmarks with a proven track record of excellence.
- Advanced treatment options: When lifestyle changes and medications alone don’t manage your aneurysm, you have access to advanced interventional procedures and surgeries, including endovascular aneurysm repair (EVAR). Our vascular surgeons are the only providers in Vermont offering catheter-based treatments as an alternative to open-thoracic surgery.
What Causes a Thoracic Aortic Aneurysm?
While the wall of the aorta is normally able to stretch and shrink as needed to adapt to blood flow, certain conditions can cause the wall to weaken, leading to an aneurysm. While their exact cause is unknown, the following risk factors are associated with thoracic aortic aneurysms:
- A family history of the condition
- Connective tissue disorders
- Atherosclerosis (the hardening of the arteries)
- Inflammation of the arteries
- Trauma to the chest
- Certain infections (such as syphilis and endocarditis)
- Tobacco use
- High blood pressure
Wellness & Prevention
Evidence shows that proactive health care focused on preventing illness leads to better outcomes. We're here to help you live a healthier, happier life. We offer wellness and prevention services to empower you to take control of your health.
Symptoms of a Thoracic Aortic Aneurysm
Most people with a thoracic aortic aneurysm do not experience symptoms, especially when the aneurysm is still small. As the aneurysm gets bigger, it can put pressure on surrounding organs and can cause symptoms. Symptoms are most common when the aneurysm occurs in the section of the aorta that curves downward (the aortic arch), and may include:
- Chest pain
- Back pain
- Cough or shortness of breath
- Difficulty swallowing
If a thoracic aortic aneurysm ruptures, you will experience sudden, severe pain, an extreme drop in blood pressure and signs of shock. Without immediate treatment, it can quickly lead to death.
Diagnosing a Thoracic Aortic Aneurysm
Thoracic aortic aneurysms are often found by chance, during tests done for other reasons. If your doctor thinks you might have a thoracic aortic aneurysm, they will conduct a physical exam and order imaging tests to confirm the diagnosis and determine the location and size of the aneurysm.
Thoracic aortic aneurysm diagnosis and testing may include:
- Echocardiogram: Creates a video image of your heart pumping blood, to evaluate its structure and blood flow
- Chest X-ray: Fully examines your heart, blood vessels, lungs and lymph nodes
- Computed tomography scan (CT scan): Provides detailed images of your organs and determine if the aneurysm needs to be repaired
- Magnetic resonance angiogram: Takes pictures of your blood vessels
- Physiological studies: Measures the amount of blood traveling through your blood vessels, with and without exercise
- Ultrasound imaging: Creates a video image of your blood vessels and check for blockages
Thoracic Aortic Aneurysm Treatment
The size, shape and growth pattern of your thoracic aortic aneurysm will determine the course of treatment your cardiologist recommends. Treatment of an aneurysm is based on the risk that it will burst (rupture).
Small aneurysms rarely rupture, so in most cases, the risks of having surgery outweigh the benefits. If you have a small thoracic aortic aneurysm, your surgeon may recommend regular observation and monitoring to keep track of the aneurysm’s growth.
Your surgeon may also recommend strategies for managing your aneurysm. They may prescribe medication to help lower blood pressure and cholesterol and suggest lifestyle changes to improve your heart health. These might include quitting smoking, being active, eating a heart-healthy diet and staying at a healthy weight.
If your thoracic aortic aneurysm is causing symptoms, is 6.0 centimeters or larger, or is growing quickly, it is more likely to rupture. In these cases, surgery to repair the aneurysm is often recommended.
Cardiothoracic and vascular surgeons at UVM Health offer two surgical options to repair thoracic aortic aneurysms at risk of rupturing. Your surgeon can help you determine which procedure is best for you.
- Endovascular aneurysm repair: In this minimally invasive procedure, your doctor inserts a man-made tube called a stent graft (endograft) through a small tube (catheter) into the artery in your groin. Using a procedure called fluoroscopy, which uses X-ray dye to see the body in detail, the doctor will guide the catheter to your aorta and insert the stent graft. The endovascular stent graft strengthens the weakened aorta to prevent the aneurysm from rupturing. This procedure requires long-term follow-up care to monitor the stent graft.
- Open surgical repair: In an open surgical repair, your surgeon will make an incision in your chest to remove the damaged part of the aorta. They will then replace that section of the aorta with a synthetic tube-like device called a graft, which allows blood to pass easily.
Locations Near You
62 Tilley Drive
Suite 101
South Burlington, VT 05403
115 Porter Drive
Middlebury, VT 05753
66 Park Street
Elizabethtown, NY 12932
133 Park Street
Malone, NY 12953
130 Fisher Road
Berlin, VT 05602
210 Cornelia Street
Ste 104
Plattsburgh, NY 12901
62 Tilley Drive
Suite 101
South Burlington, VT 05403-4407
133 Park Street
2nd Floor
Malone, NY 12953-1244
115 Porter Drive
Middlebury, VT 05753-8527
111 Colchester Avenue
Main Campus, East Pavilion, Level 5
Burlington, VT 05401-1473
