What is a Thoracic Aortic Aneurysm (TAA)?

Thoracic aortic aneurysms (TAA), while not as common as AAA, affect approximately 15,000 people each year. A TAA is an aneurysm that occurs in the chest area and can involve different areas of the upper aorta. Symptoms of TAA vary. Patients can experience chest, abdominal or neck pain, or no pain at all. A TAA may rupture causing a life-threatening situation and the need for immediate medical attention. When detected in time, TAA can often be repaired.

What Causes a Thoracic Aortic Aneurysm?

In addition to the risk factors for an AAA, certain diseases can also weaken the layers of the aortic wall and increase the risk of TAA, including:

• Marfan syndrome, a genetic connective tissue disorder
• Syphilis
• Tuberculosis
• Rarely, trauma, such as a fall or rapid deceleration in a motor vehicle accident

Symptoms and Detection

You may not feel any symptoms with TAA. Only half of patients with TAA notice symptoms. If you do have symptoms, they will depend on where your aneurysm is located and how large it is. Possible symptoms include:

• Pain in the jaw, neck, and upper back
• Chest or back pain
• Coughing, hoarseness, or difficulty breathing

How is a Thoracic Aortic Aneurysm Diagnosed?

A TAA is diagnosed by echocardiography, MRI, CT scan and/or angiography. These exams and tests can show the size of the aorta and the exact location of the aneurysm.

Treatment

The size of the aneurysm and the overall condition of the patient’s health will determine the need for referral for a surgical evaluation and/or continued monitoring with further screenings.

Treatments include:

• Medical Management - Depending on the patient’s health and risk of the aneurysm rupturing, “watchful waiting” may be recommended, with close monitoring of the aneurysm and aggressive management of risk factors, such as high blood pressure.
• Minimally Invasive Endovascular Aneurysm Repair - Endovascular repair is a newer, minimally invasive procedure for the treatment of AAA and TAA and may be an option depending on the location, size and shape of the aneurysm. By making just a small incision in the groin, the surgeon is able to insert a catheter and guide it to the aneurysm using a state-of-the-art 3-D imaging system. An endovascular graft is placed at the site of the aneurysm and creates a new route for blood flow, taking pressure off the aneurysm. The most significant advantage of endovascular repair is that it is minimally invasive, allowing for a faster recovery. In addition, patients who have endovascular repair experience less pain, spend only a few days in the hospital and return to normal activity within 2 to 6 weeks after the procedure.
• Open Surgical Repair - A vascular surgeon may recommend a surgical procedure known as open aneurysm repair to repair an abdominal or thoracic aortic aneurysm. During this procedure, an incision in the chest (for TAA) or abdomen (for AAA) is required. A synthetic graft is placed in the weakened portion of the aorta which seals off the aneurysm. The graft is very strong and allows blood to pass through the aorta without putting pressure on the aneurysm. Following surgery, the hospital stay is usually 5 to 7 days. Depending on how quickly the body heals, it may take 2 to 3 months for a complete recovery.