​​​​​​​​​Aortic aneurysm

Being diagnosed with aortic a​​neurysm is a shock to many patients. The news often comes after a screening for something completely unrelated. Many patients don't even have symptoms.

An aortic aneurysm can be a life-threatening emergency depending on its size and location, but most patients can be treated without surgery when the aortic aneurysm is caught early. You can decrease your risk for complications with healthy lifestyle changes like quitting smoking and getting high blood pressure under control.

The Christ Hospital Heart & Vascular Institute offers leading-edge screenings and treatments for aortic aneurysm, from long-term surveillance and medical management to the latest minimally invasive surgery options to repair damaged sections of the aorta.

As Greater Cincinnati's Heart Hospital^SM, our vascular experts provide comprehensive care for aortic aneurysms closer to home – no matter how complex your condition may be.

Call The Christ Hospital at 513-585-2264 to schedule an appointment with one of our aortic aneurysm experts or to request a second opinion.

What is an aortic aneurysm?

An aortic aneurysm is a balloon-like bulge in the aorta, the main blood vessel that carries blood away from the heart to the rest of the body. Aneurysms can weaken the aorta wall to the point where it can leak, tear or rupture.

Abdominal aortic aneurysms (AAA)

Abdominal aortic aneurysms occur in the section of the aorta in the abdomen. AAAs are the most common type of aortic aneurysm. They often start small and may not cause any noticeable symptoms. Others continue to grow or expand quickly, causing symptoms like:

• Deep, constant pain in the front or side of your abdomen

• Feeling full even though you haven't eaten much

• Back pain

• A pulsing feeling near your bellybutton.
  

If you experience these symptoms, seek medical care immediately — especially if the pain is sudden and intense. About 95% of AAAs are successfully treated if they're found before they rupture.

Thoracic aortic aneurysms (TAA)

Thoracic aortic aneurysms occur in the section of the aorta within the chest cavity. TAAs are less common than AAAs, with risk increasing with age.

Thoracic aortic aneurysms typically grow slowly and may not cause symptoms right away. This can make them difficult to detect in the early stages.

Signs that you may have a thoracic aortic aneurysm include:

• Difficulty breathing or swallowing if the aneurysm is pressing on your lungs, trachea (windpipe) or esophagus

• Tenderness or pain in the chest

• Pain in the jaw, neck or upper back

• Back pain

• Hoarseness

• Cough

• Shortness of breath.
  

If a TAA bursts of tears, it can cause life-threatening internal bleeding. Symptoms can include severe pain in the chest and, less commonly, pain in the abdomen, numbness or weakness in one or both legs, loss of consciousness, and stroke-like symptoms. If you experience these symptoms, call 911 or go to the emergency room right away.

Ascending aortic aneurysms

Ascending aortic aneurysm is a specific type of TAA that occurs just above the heart. This is the part of the aorta that comes out of the heart then curves downward into the chest and abdomen. Ascending aortic aneurysms can sometime cause the aortic valve to leak.

Thoracoabdominal aortic aneurysms (TAAA)

Thoracoabdominal aortic aneurysms involve segments of the aorta in both the chest and abdomen. Atherosclerosis (hardening of the arteries caused by plaque build-up), age-related degeneration of the aorta, and connective tissue disorders are often key risk factors.

What are the risk factors for aortic aneurysm?

Risk factors for aortic aneurysm include:

• Health history:  Conditions like high blood pressure, high cholesterol, atherosclerosis, and coronary artery disease can increase your risk of developing an aortic aneurysm.
  

• Smoking:  Cigarette smoking is one of the leading causes of aortic aneurysms and can make an aneurysm increase in size faster.

• Family history:  You're more likely to develop an aortic aneurysm if you have a close relative, like a parent or sibling, who has had one. Cardiovascular genetic counseling can help you understand your risk.

• Gender and age: Men and people over the age of 65 are more likely to develop an aortic aneurysm.
  

• Connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome can increase your aneurysm risk.

• Injury:  Trauma to the chest or abdomen, like being in a serious car accident, can cause bruises or tears in the aorta that may develop into an aneurysm.
  

Screening for aortic aneurysm

If your doctor suspects you have an aortic aneurysm, they may recommend a physical exam and non-invasive cardiovascular imaging to locate the aneurysm and develop a treatment plan.

Imaging tests may include:

• Ultrasound

• Chest X-ray

• Echocardiogram

• CT scan

• MRI.
  

If you have been diagnosed with an aortic aneurysm, it is important to know the warning signs of a potentially life-threatening rupture.

Get emergency treatment if you experience:

• Lightheadedness or passing out

• Rapid heart rate

• Shock

• Sudden severe pain near your stomach or in your chest or back.
  

Expert aortic aneurysm treatment at The Christ Hospital

Treatment for aortic aneurysm may vary from close monitoring to surgery, depending on the aneurysm's size and growth rate. Aortic aneurysms that are large or growing quickly may require immediate surgery.

Watchful Waiting:  Aortic Aneurysm Surveillance Program

If your aneurysm is small and you don't have any symptoms, your care team will likely monitor your health through our aortic aneurysm surveillance program. This is sometimes called "watchful waiting."

Patients in The Christ Hospital Aortic Aneurysm Surveillance Program are checked at regular intervals for changes in size and shape of the aneurysm. Your care team will also work with you on prevention strategies to keep the aneurysm from getting worse.

• Lifestyle changes – including helping you quit smoking, get to a healthy weight, improve your diet, and manage stress.
  

• Medical management – including prescription medications to lower high blood pressure and high cholesterol.
  

• Genetic counseling – testing to identify genetic markers associated with aneurysm development. Results help determine the most effective treatment and if additional family members may be at risk.
  

• Continuity of care – results and updates are communicated to your primary care physician to ensure ongoing care management.
  

Surgical treatment of aortic aneurysm

The Christ Hospital is leading the way in minimally invasive surgery for aortic aneurysm in Greater Cincinnati. Most AAAs and many TAAs at The Christ Hospital are repaired endovascularly, which involves smaller incisions, less pain and bleeding, and typically a faster recovery.

Our care team pioneered endovascular aneurysm repair in Greater Cincinnati and continues to research ways to make it available to more patients, especially those who may not be good candidates for open surgery.

• Endovascular aneurysm repair: The surgeon guides a small tube called a stent-graft to the damaged section of your aorta through an artery in the arm or leg. Once in place, the stent-graft acts as a new lining for your aorta and allows blood to flow through.
  

• Open aneurysm surgery: The surgeon accesses the aneurysm through an incision in the skin. The damaged section of the aorta is repaired with a synthetic fabric graft.
  

• Hybrid aneurysm surgery:  The surgeon uses both endovascular techniques and open surgery to repair the aorta. Hybrid surgery may be used in complex cases that may not be effectively treated by one method alone.
  

Specialized surgery for complex aortic aneurysm repair

The Christ Hospital Heart & Vascular Institute offers highly specialized surgeries for complex aneurysms. Many of these procedures are only available at hospitals with advanced heart programs and experienced cardiothoracic and vascular surgeons.

Complex surgical procedures carry risks. Our care team will review your case to make sure surgery is right for you – and provide you and your family with all the information you need so you can make informed decisions about your care with confidence.

• Ross procedure – When an ascending aortic aneurysm causes damage to the aortic valve, the Ross procedure can be combined with the aneurysm repair. The Ross procedure replaces the aortic valve with the patient's own pulmonary valve. The pulmonary valve is then replaced with a donor valve.
  

• Valve-sparing aortic root replacement (David procedure) – An aortic root aneurysm is a very specific type of TAA where the aorta connects to the heart. Valve-sparing surgery repairs the aneurysm without replacing the aortic valve.
  

• Aortic arch aneurysm repair – The aortic arch is the section of aorta that curves down into your chest. Aortic arch aneurysm repair is a highly complex procedure that can be completed endovascularly or with open surgery.
  

• Thoracoabdominal aneurysm surgery – TAAA surgery is extremely complex because it involves large sections of the aorta that extend from the chest into the abdomen. It can be completed endovascularly or with open surgery.
  

If you've been told you need to seek aortic aneurysm outside of Greater Cincinnati, or if you live in an area where complex surgical repair for your aneurysm is not available, please call The Christ Hospital at 513-585-2264 so we can discuss your case and help you explore your options.

Are you exploring your options for aortic aneurysm care?

Call The Christ Hospital at 513-585-2264 to:

• Schedule an appointment with an aortic aneurysm expert

• Request a second opinion

• Refer a patient.
  

Why choose The Christ Hospital Health Network

If you experience symptoms of an aortic aneurysm, or if you've already been diagnosed, you'll find the care and support you need at The Christ Hospital Health Network, Greater Cincinnati's leader in cardiovascular care. The Christ Hospital continually researches new techniques for treating aortic aneurysms.

• Top 50 heart hospital. The Christ Hospital has been named one of America's 50 Best Hospitals for Cardiac Surgery by HealthGrades and one of the World's Best Hospitals for Cardiology by Newsweek.

• Specialized expertise.  We offer the most extensive expertise across the spectrum of heart and vascular care. Our doctors are known leaders in cardiovascular care and are focused by specific conditions

• Treatment options.  Our patients benefit from a wider range of personalized treatment options than at many other hospitals. We take a progressive approach to aortic aneurysm management.
  

• Clinical research. Our doctors have developed many new techniques in cardiovascular medicine over the past 20 years. Patients have access to treatments not found at many other hospitals.
  

• Heart and vascular support groups.  For patients with heart-related conditions, we offer education and support. We encourage you to share your experiences to learn how to live your healthiest life.