Thoracic Aortic Aneurysm

The part of your aorta that goes through your chest is called the thoracic aorta. When a weak area of your thoracic aorta expands or bulges, it is called a thoracic aortic aneurysm (TAA). Approximately 25% of aortic aneurysms occur in the chest. Aneurysms of the thoracic aorta will affect about 10 out of every 100,000 patients each year. 

Causes and Risk Factors for Thoracic Aortic Aneurysm

The most common cause of a thoracic aortic aneurysm is atherosclerosis, or a hardening of the arteries. In rare cases, trauma, such as a fall or rapid deceleration in a motor vehicle accident, may cause TAA.

Some of the risk factors for TAA include:

  • Advanced age
  • Smoking
  • High blood pressure
  • Atherosclerosis
  • Hyperlipidemia 
  • High cholesterol
  • A family history of heart disease
  • Connective tissue disorders such as Marfan syndrome
  • Previous dissection of the aorta
  • Syphilis
  • Tuberculosis
  • Trauma

Symptoms of TAA

Only half of patients with TAA notice symptoms. It may be found when tests (such as an X-ray, MRI or CT scan) are done for an unrelated problem. If you do experience symptoms, they will depend on the location of your aneurysm and how large it is. Possible symptoms include:

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

Diagnosing Thoracic Aortic Aneurysm

Most thoracic aortic aneurysms are detected by tests that are run for unrelated reasons. A chest CT scan can show the size of the aorta and the exact location of the aneurysm. An aortogram is a special set of X-ray images made when dye is injected into the aorta. It can identify the aneurysm and any branches of the aorta that may be involved.

Your physician will order one or more of the following tests to diagnose TAA:

  • Chest X-ray
  • Echocardiogram (an ultrasound of the heart)
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT) scan
  • Angiography

Treating Thoracic Aortic Aneurysm at St. Joseph's Heart & Vascular Institute

Thoracic aortic aneurysm repair involves removing the aneurysm through open surgery or endovascular stent graft repair. Our surgeons perform both procedures:

  • Open surgical repair
  • TEVAR – a newer, less invasive approach utilizing thoracic endovascular aneurysm repair. This technique involves a small incision. TEVAR in appropriate patients can significantly reduce recovery time, blood loss, paraplegia risk and wound complications.

Your doctor will weigh the chances that the aneurysm will burst against the risks of surgery. Because a small aneurysm is not likely to burst, it may be monitored for a while. When it reaches a certain size, you may have surgery to replace that section of your aorta.