Aorta diseases

Aortic aneurysm

An aortic aneurysm is a fairly common disease that occurs in about 1 in 20 people older than 65. The aneurysm rupture is often fatal. It is possible to replace the affected area of the aorta with an artificial vascular prosthesis surgically and prevent a dangerous complication.

The aorta is the largest artery in the body. Blood enters the aorta from the heart, then through numerous arterial branches goes to all organs. The aorta goes from the heart upward, forms an arc, then descends, passing in the chest (thoracic aorta) and in the abdomen (abdominal aorta).

Approximately 25% of all aneurysms occur in the thoracic part, the remaining 75% occur in the abdominal part of the aorta.

What is an aortic aneurysm?

An aortic aneurysm is an enlargement or bulge in the aortic wall. An aneurysm of the aorta part that passes through the belly area (abdominal aortic aneurysm) is more common. Less often, the aorta in the chest is affected (thoracic aortic aneurysm).

The aortic wall in the aneurysm area is much weaker than normal, so it may not be able to withstand blood pressure from within. This can lead to the rupture of the aneurysm. The risk of this complication depends on the size of the aneurysm.

If the aneurysm diameter is greater than 5 cm, then 25 patients out of 100 will have a rupture within 8-9 years. The risk increases with the size of the aneurysm.

In some cases of a small aneurysm, surgery may not be required at the moment, but then it is necessary to undergo an examination every 6 months.

Symptoms

In most patients, an aortic aneurysm can develop for several years before any signs of disease (symptoms) appear. The manifestations of the aneurysm depend on which part of the aorta is affected.

Symptoms of aortic dissection appear suddenly. For example, severe tearing pain in the chest, abdomen or back. An aneurysm rupture leads to severe internal bleeding, which is fatal unless emergency surgery is performed.

It is very important to see a doctor immediately if you experience these symptoms. Delay may lead to the development of life-threatening complications.

Causes of aneurysms

The main cause of aneurysm development is atherosclerosis. This is a disease when cholesterol, calcium and fibrous tissue are deposited in the artery wall (atherosclerotic plaque), which leads to its weakening and protrusion.

There are several risk factors for atherosclerosis and aneurysm development:

sex (men are more likely to develop aortic aneurysms),
smoking,
age (aneurysm is more likely to develop at an older age - especially after 55 years),
family history,
high blood pressure (higher than140/80),
lack of physical activity,
being overweight.

Much less common causes of aortic aneurysms are:

trauma (for example, in car accidents)
infections (syphilis)
rare congenital diseases (thoracic aortic aneurysms are common in Marfan's syndrome)

Diagnosis

The diagnosis is often made during the collection of complaints and physical examination (when the doctor feels a pulsating formation in the patient's abdomen). If an aortic aneurysm is suspected, the following examinations are performed:

Ultrasound examination (US)
Computed tomography (CT)
X-ray contrast angiography

Treatment

The choice of aneurysm treatment depends on the presence of symptoms and the size of the aneurysm.

Emergency surgery is needed for aneurysm rupture. Such operations are accompanied by a much greater risk for the patient than elective operations, when it is possible to fully examine the patient and carefully prepare for surgical intervention.

In case of atherosclerosis, not only the aorta is affected, but also other arteries, in particular, the arteries of the heart (coronary arteries) and the carotid arteries that supply the brain. Therefore, before performing an operation for an aortic aneurysm at Bakulev Center, a thorough examination of all vascular pools is carried out in order to minimize the risk of surgery.

The operation consists in replacing the affected area of the aorta with an artificial vascular prosthesis.

Prevention

quit smoking
keep your blood pressure under control
lead an active lifestyle
lose weight if your are overweight

Departments and specialties

Bakulev Center has an extensive experience in the treatment of aortic aneurysms. More than 100 open or endovascular operations are performed here annually, and very good results have been achieved - mortality does not exceed 1%, the frequency of other complications is minimal. After a thorough examination, experienced specialists will offer you an optimal treatment program and help you cope with this grave, but curable disease.

Departments that treat this condition

Department of reconstructive surgery and aortic arch

Division of arterial pathology surgery

Doctors