What Are the Treatments for an Ascending Aortic Aneurysm?

Aneurysms occur due to weakening of the walls of the arterial blood vessels. This weakened portion of the artery can become further damaged, balloon out and could even rupture, resulting in a serious life-threatening situation. The most common aneurysms occur in the brain or aorta, which is the largest artery in the body. Depending on the portion of the aorta that is affected, the aneurysm may be called an abdominal descending or an ascending aorta aneurysm.

Definition

• An ascending aorta aneurysm is also called an ascending aorta thoracic aneurysm because it's an aneurysm occurring in the thoracic area where the aorta passes into the chest. These aneurysms occurs 25 percent of the time and are usually caused by atherosclerosis (hardening of the arteries).

Symptoms

• A patient may have an ascending aorta aneurysm and remain asymptomatic. However, symptoms of an ascending aorta aneurysm include a dry cough, hoarseness and vocal cord paralysis. In addition, patients may experience shortness of breath, a pulsating headache or pulsating chest pain, and dysphagia (or difficulty swallowing).

Diagnosis

• The tools used to diagnose an ascending aorta aneurysm are medical history and a physical examination. A chest X-ray or computerized tomography (CT) scan of the chest will show the size and exact location of the aneurysm. An aortogram is an X-ray that can identify the aneurysm and the arterial branches of the aorta that are affected.

Treatments

• The size and location of an ascending aorta aneurysm is of importance in deciding when surgical treatment should be done. An aneurysm in front and near the heart that is 5 cm to 5.5 cm in diameter is an indicator for surgery. Urgent surgical treatment is usually done for an ascending aorta aneurysm. This includes locating the aneurysm, controlling the bleeding and removing the damaged portion of the aorta. This portion is replaced with a Dacron tube graft.

Aortic Root Replacement

• When there is damage to the aortic valve, an aortic root replacement may be necessary. There are various techniques used for aortic root replacement or repair. They include reconstruction using biological valves like stentless xenograft and composite root replacement with a mechanical valve conduit. These techniques will require cardiopulmonary bypass and the lowering of the body's temperature in order to perform the repair.

Considerations

• There are some complications that may occur after aortic surgery. However, the risk of not having the surgery could be serious. Complications include bleeding, infection of the graft and heart attack. In addition, irregular heartbeat, kidney damage or a stroke could occur.

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