Thoracic Aortic Aneurysm

A thoracic aortic aneurysm occurs when there is a weak area in the aorta that expands or bulges. If it bursts or ruptures forming a tear in the artery wall, it can cause life-threatening internal bleeding. At the UVM Medical Center, our team uses the most advanced technology available to diagnose and treat thoracic aortic aneurysms.

Thoracic Aortic Aneurysm Care at UVM Medical Center

At the UVM Medical Center, we have a team of highly skilled vascular and cardiovascular surgeons that uses that latest technology to treat thoracic aortic aneurysms. When choosing us for your treatment, you will benefit from our advanced facility that includes a nationally accredited non-invasive diagnostic laboratory.

Our surgeons, radiologists and cardiologists work together to provide expert care to our patients. Patients are often able to meet with a surgeon and have an imaging study, such as an echocardiogram, done on the same day. We also offer endovascular aneurysm repair, a minimally invasive procedure that reduces recovery time and the risk of complications.

Thoracic Aortic Aneurysm: An Overview

The aorta is the largest artery in the body and is about 1 inch in diameter. With a thoracic aortic aneurysm, the pressure of blood flowing through the weakened area can cause it to stretch. An aneurysm can develop anywhere along the aorta, which runs from your heart through your abdomen. Depending on the location, it can either be a thoracic aortic aneurysm or ora abdominal aortic aneurysm (AAA).

The exact cause of thoracic aortic aneurysm is unknown, but several factors increase your risk. Some of these risk factors include tobacco use, high blood pressure, age, family history and connective tissue diseases like Marfan syndrome.

Thoracic Aortic Aneurysm Diagnosis

The UVM Medical Center's vascular technologists and imaging specialists are specially trained in the latest technology to diagnose vascular problems. We have a nationally accredited non-invasive diagnostic laboratory. This lab is staffed by registered vascular technologists, who are highly skilled specialists with advanced training in vascular imaging and testing. The diagnosis process may involve:

• Echocardiogram - a noninvasive test using ultrasound waves to evaluate your heart's structure and blood flow. A computer translates the ultrasound waves into an image of your heart. This image is then displayed on a television monitor and can be recorded.
• Computed Tomography (CT or CAT) scan - we offer the most advanced CT technology available, providing detailed images of organs within just seconds. A CT scan may be recommended if your aortic aneurysm has grown to a certain size to determine if it needs to be repaired.
• Chest X-ray - this painless test creates a picture of the chest that shows your heart, lungs, airway, blood vessels and lymph nodes.
• Magnetic Resonance Angiogram (MRA) - another painless, imaging test that is a type of magnetic resonance imaging (MRI) scan. It uses a magnetic field and pulses of radio wave energy to make pictures of the blood vessels inside your body.
• Physiological Studies - these studies measure the amount of blood traveling through the vessels with and without exercise. They help determine if blockages exist.
• Ultrasound Imaging - this is an imaging study that uses sound waves to produce a video image of your blood vessels. We use ultrasounds to check for a potential aortic aneurysm, as well as blocked blood vessels in the neck, abdomen or extremities. In some cases, it may be the only test necessary to determine if an operation or stenting procedure is needed.

Treatments for Thoracic Aortic Aneurysm

The size, shape and growth patterns of your thoracic aneurysm determine the course of action your team of physicians recommends. If your aneurysm is causing symptoms, is 1.9 to 2.4 inches or larger, or is found to be growing, a surgical procedure may be necessary.

The UVM Medical Center's highly skilled vascular surgeons are devoted to the treatment of diseases of the vascular system. All surgeons are fully certified by the American Board of Surgery with special qualifications in Vascular Surgery.  Treatment options for thoracic aortic aneurysms include:

• Regular Monitoring - If your thoracic aortic aneurysm is small, all you need may be regular observation and monitoring. Monitoring is done with periodic imaging tests, such as an echocardiogram, to detect any changes in size. Medications may be used if you have high blood pressure or high cholesterol. In addition, you should quit tobacco use if you are a smoker.
• Endovascular Aneurysm Repair - This is a minimally invasive procedure where a stent graft (or endograft) is placed into the weakened aorta. The endovascular stent graft strengthens the weakened section of the aorta to prevent the aneurysm from rupturing.
• Open Repair - With an open surgical repair, your surgeon makes an incision in your chest to remove the damaged part of the aorta. Then a synthetic tube-like device called a graft is sewn into place. The graft takes the place of the weakened part of the aorta and allows blood to pass easily.

Recovery time for endovascular aneurysm repair is usually shorter than for open chest surgery. Long term follow-up car is needed to monitor the stent graft.