(AAA; Abdominal Aortic Aneurysm; Aneurysm, Abdominal Aortic; Thoracic Aortic Aneurysm; Aneurysm, Thoracic Aortic)
An aortic aneurysm is a weak, bulging area in the wall of the aorta. The bulging develops from a weakness or defect in the aortic wall and tends to get bigger with time. The aorta is the body's largest artery. It carries blood from the heart for delivery to the rest of the body. The aorta travels through the chest (thoracic aorta) and the abdomen (abdominal aorta). Abdominal aortic aneurysms are more common than thoracic aortic aneurysms.
The greatest danger is that an aneurysm will rupture. This will cause heavy, uncontrollable bleeding (hemorrhage). Aortic aneurysms can also occur with aortic dissection. Dissection is defined as a small tear in the aortic wall. Blood from the aneurysm can leak through this tear and spread between the layers of the aortic wall, eventually leading to rupture of the vessel.
Aneurysms can develop anywhere, but are most common in the aorta, iliac artery, and femoral artery.
|Abdominal Aortic Aneurysm|
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Atherosclerosis is frequently associated with aneurysm. However, it is not thought that this disease alone causes the growth of an aneurysm. It is believed that other factors, such as high blood pressure or connective tissue disorders, must be present for an aneurysm to form.
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for an aortic aneurysm include the following:
Many aneurysms do not have symptoms and are detected during a routine physical exam or during X-ray evaluation for another disorder.
Symptoms may occur when the aneurysm grows or disrupts the wall of the aorta. Symptoms depend on the size and location of the aneurysm and may include:
The doctor will ask about your symptoms and medical history, and perform a physical exam. Pain is the symptom that will most likely cause you to go to the doctor. Most aortic aneurysms are discovered during a routine physical exam.
Tests may include:
Treatment includes surgery or stenting.
Surgery to repair an aortic aneurysm is called aneurysmectomy. It involves removing the portion of the aorta that contains the aneurysm and replacing it with a mesh graft.
With aneurysms of the thoracic aorta, the aortic valve may also be affected and need to be replaced or repaired. If the aneurysm involves important branches of the aorta, these vessels may either be repaired or bypassed.
When deciding whether to operate, the doctor will consider:
There are no guidelines for preventing an aneurysm because the cause is not known. However, you can reduce some of your risk factors by following these recommendations:
American Heart Association http://www.americanheart.org/
The National Heart, Lung and Blood Institute http://www.nhlbi.nih.gov/health/
Canadian Cardiovascular Society http://www.ccs.ca/index.php/en/
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/splash/
Aneurysm, aortic. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4455 . Accessed July 8, 2009.
Braunwald E. Heart Disease: A Textbook of Cardiovascular Medicine . 6th ed. Philadelphia, PA: WB Saunders Company; 2001.
Cecil RL, Goldman L, Bennett, JC. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Sabiston DC, Townsend CM. Sabiston Textbook of Surgery . 16th ed. Philadelphia, PA: WB Saunders Company; 2001.
US Preventive Services Task Force. Screening for abdominal aortic aneurysm: recommendation statement. Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov/clinic/uspstf05/aaascr/aaars.htm . Accessed July 8, 2009.
7/21/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Thompson SG, Ashton HA, Gao L, Scott RA, Multicentre Aneurysm Screening Study Group. Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomized Multicentre Aneurysm Screening Study. BMJ. 2009;338:b2307.
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The following Steward Centers for Cardiac and Vascular Care offer treatment (surgical and/or non-surgical) for this condition: