Aortic Aneurysm


What is aorta?
Aorta is the main blood vessel that comes out of the heart. Blood flows through the aorta to the rest of the body. It crosses the chest, the belly and then branches to supply blood to the legs. The “thoracic aorta” is the part of the aorta that stays inside the chest and the “abdominal aorta” is the part of the aorta that stays inside the belly.


What is aortic aneurysm?
Aortic aneurysm is a problem in which part of the aorta gets dilated like a balloon. This dilated vessel can rupture, cause internal bleeding and lead to death.


What are the symptoms of aortic aneurysm?
Most people with aortic aneurysms have no symptoms. When symptoms do occur, they can include:
 
  • Pain in the belly or back
  • A small lump in the upper part of the belly that pulses

Aortic aneurysms can burst anytime with no warning. People at a greater risk to have aortic aneurysm should get tested for early diagnosis.


Who is most likely to get an aortic aneurysm? 
Your risks go up if you:
 
  • Are a man
  • Are older than 60 
  • Smoke
  • Are white
  • Have family members who have had the condition
  • Have heart disease or other conditions that affect the blood vessels


Can aortic aneurysms be prevented?
No. But you can greatly reduce your risk by not smoking. If you have high blood pressure, it is also important to control your blood pressure.


Is there a test for aortic aneurysm?
Yes. The vascular surgeon can diagnose an aortic aneurysm with careful belly examination.  In order to confirm and get details of each case, he may need imaging exams, such as ultrasound, computed tomography or magnetic resonance. Many times, people do an exam for another reason and discover an aortic aneurysm.


How are aortic aneurysms treated? 
Treatment depends on how big the aneurysm is. Large aneurysms need surgical repair to avoid rupture. Small or slow-growing aneurysms rarely burst, and do not need surgery. 


What is recommended for the small aortic aneurysms?
People with small aortic aneurysms should get tested every six months to one year to see how fast your aneurysm is growing. In case of pain in the belly or back, the vascular surgeon must be sought.


When should aortic aneurysms be repaired? 
Aortic aneurysms should be repaired if it is at risk of bursting. Here are some signs that an aneurysm might burst:
 
  • It is bigger than 5,5 centimeters wide in the abdominal aorta
  • It is bigger than 6,0 centimeters wide in the thoracic aorta
  • It grows more than 0.5 centimeters in 6 months

How are aortic aneurysm repaired?
Aneurysms can be fixed in one of two ways:
 
  • Traditional “open” surgery – the vascular surgeon replaces the diseased aorta with a synthetic tube called “graft.” To do so, a cut in the belly is required.
     
  • Endovascular surgery – the vascular surgeon makes two small cuts in each groin and inserts a folded graft in the blood vessels. Then the doctor threads the graft up to the bulging part of the aorta and unfolds it, treating so the aneurysm.


Which is the best procedure?
Open surgery is a little riskier in the short term. But it fixes the problem for good. Endovascular repair is less risky in the short term. But it needs to be carefully followed. That’s because endovascular grafts sometimes slip out of place and need to be fixed. Besides, not every case is suitable to endovascular surgery.  If the vascular surgeon suggests open or endovascular surgery, it is important to ask these questions:
 
  • What are the risks of each procedure?
  • What kind of follow up is required with each option?
  • What is likely to happen if I do not have any treatment?

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