An aortic aneurysm is a bulge in a section of the aorta, the body's main artery that runs from the heart through the centre of chest and abdomen. A normal size aorta, at about 2-3 cm in diameter, supplies oxygen-rich blood from the heart to the rest of the body.
Aneurysms can form in any section of the aorta, but they are most common in the belly area called abdominal aortic aneurysm. They can also happen in the chest area called thoracic aortic aneurysm. Thoracic aortic aneurysms are also known as ascending or descending aortic aneurysms.
Because the aorta is the body’s main supplier of blood, a ruptured aortic aneurysm can cause life-threatening bleeding which requires an emergency surgical treatment within 48 hours.
Dr. Attapoom Susupaus, Cardiothoracic Surgeon, Bangkok Heart Hospital, explains the risk factors and surgical treatments to fit individual requirements.
Dr. Attapoom Susupaus Cardiothoracic Surgeon Bangkok Heart Hospital
“Men generally have a four times higher risk of developing aortic aneurysm than women. High blood pressure, high cholesterol, and smoking cigarettes are major factors that weaken the artery walls. Aging above 65 years is also a factor in that it naturally generates wear and tear on the arteries and can result in a weak aortic wall that bulges outward.”
“Some genetic transmission, such as Marfan’s syndrome and Loeys-Dietz Syndrome, for example, make the walls of the major arteries, including those of the aorta, weakened. Infectious and inflammatory diseases, such as syphilis and giant-cell arteritis, also deteriorate the artery walls. A sudden, intense blow to the chest or abdomen, such as hitting the steering wheel in a car accident, can damage the aorta and cause an aortic aneurysm.”
Most people with aortic aneurysms do not have symptoms. However, symptoms may begin to occur if the aneurysm gets to approximately 4-5 cm. in diameter and puts pressure on surrounding organs.
“Symptoms of the thoracic aortic aneurysm include chest and back pain, hoarseness, cough and shortness of breath, while abdominal aortic aneurysm generating a pulsating feeling near the navel, deep and constant pain in abdomen or on the side of abdomen and back pain.”
“Another complication of aortic aneurysms include the risk of blood clots. Small blood clots can develop in the area of the aortic aneurysm. If a blood clot breaks loose from the inside wall of an aneurysm and blocks a blood vessel elsewhere in the body, it can cause pain or block the blood flow to the legs, toes, kidneys or abdominal organs.”
“If the aortic aneurysm is small, the doctor may recommend medical monitoring which would include regular appointments to make sure that no aneurysm is developing. On the other hand, if an aortic aneurysm is larger than 5 cm. and a painful ruptured aneurysm is occuring, a surgical treatment needs to be performed within 24-48 hrs. or as soon as possible.”
“Life-threatening situations requires good management and timing, complete equipment and a professional team of medical specialists in the applicable fields.”
To confirm size, shape and location of the aneurysm, a CT scan is performed to provide the doctor with clear images. There are two major surgical treatment options: open surgery and minimally invasive procedure. The selection of option will be determined by the cardiothoracic surgeon with respect to the particular requirements of the case.
Open surgery is suitable for young and healthy patients. The surgery involves removing the damaged section of the aorta and replacing it with a synthetic tube (vascular graft) which is sewn into place. This procedure will generally take a month or more to fully recover.
A minimally invasive procedure (Endovascular surgery) is suitable for seniors or patients with complications who can’t endure open treatment. The doctor makes two small incisions in the groin. A stent is attached to the end of a thin tube (catheter) which is inserted through the artery and threaded up into the defective aorta. The stent is then fastened in place so as to reinforce the weakened section of the aorta and prevent rupture of the aneurysm. Recovery time is much shorter than for open surgery. However, annual imaging testing follow-up is required to ensure that the stent stays in position.
“We can prevent an aortic aneurysm by consuming healthy foods, exercising regularly and avoiding smoking. An aortic aneurysm screening using an ultrasound or CT scan is recommended for people age 65 up and persons below 65 years of age who are at risk of aortic aneurysm.”
For further information or medical advice, please contact 1719 or visit www.bangkokhearthospital.com
