Thoracic Aortic Aneurysm

A thoracic aortic aneurysm is a bulge that develops in a weakened wall of the part of the aorta located in the chest. Because the aorta is the major blood vessel that feeds blood throughout the body, this type of aneurysm can become life-threatening.

Symptoms of Thoracic Aortic Aneurysm

Thoracic aortic aneurysms typically grow slowly. When they are small, they usually don’t cause symptoms, which makes them difficult to detect. Some thoracic aortic aneurysms remain small and never cause problems, but larger ones can lead to symptoms that include:

• Tenderness or pain in the back and chest
• Hoarseness and dry cough
• Shortness of breath

If you think you may be experiencing symptoms of a thoracic aortic aneurysm, contact your doctor promptly.

Diagnosing and Repairing Thoracic Aortic Aneurysm

If imaging studies confirm the presence of a thoracic aortic aneurysm and show it to be larger than five centimeters, the cardiologist may recommend an endovascular repair.

The minimally invasive nature of this procedure helps patients recover more quickly and has a lower rate of complications than a traditional surgical repair.

Endovascular aneurysm repair is surgery performed inside the aorta (endovascular), using long tubes and imaging guidance to insert a stent graft that diverts blood away from the aneurysm.

After a patient is given numbing medication and a sedative, the cardiologist will make only one small incision—in the upper thigh, in a femoral artery that supplies blood to the leg.

The cardiologist feeds a guide wire through the artery and beyond the site of the thoracic aneurysm. The stent, which is contained within a catheter, is guided to the site over the guide wire.

Once in place, the catheter is removed, leaving the stent-graft to expand against the walls of the aorta on either side of the aneurysm. This reinforces the walls and helps the blood flow freely through the region. 

What to Expect Before, During and After Surgery

Before Surgery

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Clopidogrel (Plavix), warfarin (Coumadin) and other blood thinners.
• Ask your doctor which of your medications you should still take on the day of the surgery.
• Discuss any possible bleeding disorders or other medical conditions that you may have.
• You will have blood samples taken in case you need a blood transfusion.
• Let your doctor know if you have a cold, flu, fever, herpes breakout or other illness prior to surgery. An illness may require that your procedure be postponed.
• Do not smoke. This will help you to recover more quickly.

On the Day of the Surgery

• You will usually be asked not to drink or eat anything after midnight the night before the surgery.
• Take the medications your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After Surgery

• You will remain in the hospital for two to three days following the procedure.
• You will have a dressing over your surgical site for the next few days. You will need to keep it dry and avoid showering.
• You will not be able to drive for one to two weeks after surgery.
• Avoid lifting anything weighing more than 10 pounds for four to six weeks after surgery.
• This surgery has a quick recovery with most patients feeling much better within the first week, but full recovery takes four to six weeks.

Recovery

• While you may feel much better after the first post-surgical week, you need to follow your physician’s orders about recommended and restricted activities.
• You will have follow-up appointments and additional imaging tests one month and six months after surgery to ensure that the stent is functioning correctly and has remained in place.
• If all is well, your doctor may recommend that you have yearly tests to check on the site.

Make an Appointment

If you or someone you love is experiencing symptoms of a thoracic aortic aneurysm, make an appointment today with one of WakeMed’s specialized cardiologists.

• Request a Heart and Vascular Appointment
• Refer a Patient (Physicians)