What is Aortic Arch Aneurysm?

The aorta is your largest artery and it brings oxygenated blood to all parts of the body. If the walls of the aorta become weak, an enlargement can occur. This is known as an aortic aneurysm.

Aneurysms can form in any section of the aorta, but are most common in the abdomen (abdominal aortic aneurysm) or the upper body (thoracic aortic aneurysm). The part of the aorta closest to the heart is called the aortic arch. There is reason to be concerned if you have an aortic aneurysm: If the size is too large, it could rupture, which is extremely dangerous and can cause life-threatening bleeding.

Baptist Health is known for advanced, superior care for patients with heart disease and aortic arch aneurysm diagnosis, management and repair. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

An aortic arch aneurysm can be slow to grow and exhibit no symptoms. That’s why regular checkups are important. But as an aneurysm enlarges, symptoms like these may be noticed:

• Wheezing, coughing or shortness of breath
• Coughing up blood
• A raspy voice
• Difficulty swallowing
• Pain in the chest or back

Diagnosis

Early diagnosis is critical in managing an aortic arch aneurysm. To diagnose an aortic arch  aneurysm, we ask questions about your medical history and do a physical exam. We then use advanced technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Angiogram: A thin tube (catheter) is inserted into a blood vessel and dye is injected to make the blood vessel visible during an X-ray. This can show any blood clots or other blood vessel issues.

Chest X-ray: A common imaging test of the lungs, heart and aorta.

CT scan:X-rays and computers are used to create images of the aorta, heart and blood vessels. This provides a more detailed picture than an ultrasound.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Magnetic resonance imaging (MRI):A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Causes

There are a number of factors that can cause the walls of the arteries to weaken and lead to an aneurysm. While an aortic arch aneurysm is relatively rare, it can be caused by:

• Buildup of fat and plaque on the lining of the arteries
• Connective tissue disorders
• High blood pressure

Risk Factors

Risk factors that could contribute to an aortic aneurysm include:

Age: Most aortic arch aneurysms occur in people over age 65.

Heart murmurs: Heart murmurs can be linked to a damaged or over-stressed heart.

History of high blood pressure: High blood pressure weakens artery walls.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent an aortic arch aneurysm:

Practice good heart health: Watch what you eat, exercise daily and avoid smoking,

Take your medications as prescribed: If you have high blood pressure, high cholesterol or diabetes, be certain to take your prescribed medications as directed.

Get scanned: If you are over age 65 and at a higher risk for aortic aneurysm, your doctor may suggest a simple screening test. It’s a painless and fast ultrasound that can determine if an aneurysm is forming.

Prognosis

Prognosis is usually good when an aortic arch aneurysm is treated before it ruptures.

Treatment and Recovery

Treatment for an aortic arch aneurysm depends on its size, location and your overall health. Once an aortic arch aneurysm has been diagnosed, our goal is to develop an individualized plan to treat it so it will not develop to a dangerous level and rupture. Depending on the size of the aneurysm, treatment can include:

Medication

If the size of the aortic arch aneurysm is small, medication may be used to slow its growth rate. It is imperative that your blood pressure be monitored and blood pressure medication be taken as prescribed. A statin medication, which lowers cholesterol and can help keep your blood vessels healthy, may also be prescribed. Regular testing is an important way to keep a watchful eye on the aneurysm.

Surgery

The most effective treatment for a larger, fast-growing or leaking aneurysm is surgery. You may be recommended for traditional open surgery or a less invasive procedure called endovascular surgery. The type of procedure recommended for you depends upon the location and appearance of the aneurysm and your health.

During open surgery, the weakened aortic arch is replaced with a plastic or fabric graft. If the aneurysm is close to the aortic valve (the valve that regulates blood flow from the heart into the aorta), a valve replacement may also be recommended during the procedure.

During endovascular surgery, a stent graft is positioned inside the diseased section of the aorta. The stent acts as a liner to divert blood flow away from the aneurysm.

Recovery After Surgery

Depending upon how your body heals, you will be in the hospital for up to 10 days after open surgery and it may be three to six months before you feel able to fully resume your normal activities. After endovascular surgery, you will be in the hospital for a few days and it may be four to six weeks before you fully recover.

Complications

If an aortic aneurysm is not diagnosed and treated, the aneurysm could cause serious health problems. Those problems can include:

Rupture: Because the aorta is the main supplier of blood to the body, a rupture could cause life-threatening bleeding. This creates an emergency surgical situation.

Blood clots: Blood clots can weaken the heart and affect its ability to pump blood through the body. If a blood clot breaks loose, it could block a blood vessel anywhere in your body.