Surgical consult and lifelong surveillance recommended for all aneurysms greater than 4.0 cm
Ascending Aorta Aneurysm
Aortic Arch Aneurysm
Descending Aorta Aneurysm
Thoracic aortic aneurysms (TAA) are a localized ballooning of the thoracic aorta, defined as at least 50 percent increase in size compared to the normal aorta. Enlargement of TAAs is unpredictable; most are characterized by periods of stability interspersed with periods of expansion. Its course typically consists of progressive aneurysm enlargement and eventual rupture. The larger the aneurysm at the time of diagnosis, the greater the chance for rupture. For this reason, it is very important to refer or treat large or unstable TAAs early to prevent rupture.
Medical therapy is an option for stable, small TAAs. Yet, once enlarging or symptomatic, intervention is required. At present, there are two treatment options.
Asymptomatic. If symptoms develop, they can be diverse: pain in the jaw, neck, upper back, chest or shoulder; chest pain; and distal embolization are possibilities. In addition, coughing, hoarseness or difficulty swallowing or breathing may occur.
Although TAAs often go unnoticed, they may appear in a routine chest x-ray and should be further evaluated by CT scan, intravascular ultrasound, diagnostic angiogram or transesophageal echocardiogram.