Aortic Aneurysm

What is it?
An aneurysm is an area of enlargement of a blood vessel due to the weakening of the vessel wall thus causing a bulge. If the aneurysm remains undetected, the area could rupture which is referred to as a dissection. In Cardiothoracic Surgery we specifically deal with aneurysms in the chest (thorax), not abdominal aneurysms. [These may be referred to as an ascending aortic aneurysm, or an aortic arch aneurysm] The type of aneurysm refers to its location in the chest. For example, an aortic arch aneurysm is a bulge along the arch of the aorta.
What are the symptoms?
The symptoms of an aneurysm are often vague, or nonexistent. In some instances if the aneurysm grows rapidly, the patient may experience chest or back pain.
Aneurysms are often without any definitive symptoms. However, if the patient should have a pre-existing medical condition such as Marfan's Syndrome, they should be checked regularly with chest x-ray or CT scan.
Diagnosis
Aneurysms are associated with certain medical conditions, such as Marfan's Syndrome or untreated hypertension. In the case of Marfan's, the patient should be evaluated regularly with chest x-ray or CT scan since aneurysms are very often without definitive symptoms. In most instances aneurysms are usually detected as a result of a chest x-ray done for some other medical evaluation. It will show up as a mass. A CT scan or an MRI is then used to determine the exact size and location of the aneurysm.
Treatment
If an aneurysm is diagnosed, a surveillance protocol is initiated to chart the size of the aneurysm along with medical management which may include a combination of diet, exercise, and medication aimed at reducing blood pressure. If the aneurysm continues to grow and reaches the calculated size (usually 6 cm) indicative of possible rupture, then surgery is discussed with the patient. Surgery is the only cure for an aortic aneurysm. However, the timing of surgery is based on the risk of surgery versus the risk of rupture.
Surgical repair of the aneurysm is done through an incision made along the left side of the chest, under the arm (left lateral thoracotomy) and the repair is made. Recovery from this procedure is usually 5 to 7 day stay in the hospital with a 4 to 6 week complete recovery.