The natural history of thoracic aortic aneurysms

Case Scenario

“…12 Dapunt et al looked at the risk factors for aneurysm expansion and found that a history of hypertension, male sex, age older than 70 yr, history of smoking, and initial aneurysm diameter more than 5 cm at diagnosis were independent predictors of rapid expansion. 13 A prospective study in which more than 500 TAAA patients were followed over 9 yr revealed the annual rupture or dissection rate was 7% for aneurysms more than 6 cm. 14 This same study showed preemptive surgical repair restored normal life expectancy.…”

Comparison of Operative Techniques in Acute Type A Aortic Dissection Performing the Distal Anastomosis

“…Marfan's, Turner's, Noonan's and Ehlers-Danlos syndromes) and arterial hypertension are main risk factors for development of an acute aortic dissection. 2,18 Operative correction and replacement of the dissected ascending aorta including the entry is evidently indicated. Nevertheless, there is an ongoing discussion on the preferable approach for surgical treatment.…”

Hidden lesion easily missed on chest radiography

“…1 Without surgical repair, thoracic aortic aneurysms larger than 6 cm have higher rates of expansion and rupture (a 20% 6-year cumulative risk) than smaller ones. 2 Mid-descending aortic aneurysms expand faster than those of the ascending aorta. 3 Indications for surgery include rupture, severe chest pain, compressive symptoms, large size (eg, ≥ 5.5 cm for asymptomatic descending thoracic aneurysms), and rapid growth rate (≥ 10 mm per year), all of which are associated with a higher mortality rate.…”