An aortic root aneurysm is a bulging of the aortic root, the section of the aorta where it branches off from the left ventricle of the heart. The aortic root contains the aortic valve, which regulates the flow of blood from the heart to the rest of the body.
There are many potential causes of an aortic root aneurysm, including:
- Genetics and family history of aneurysms
- Connective tissue disorders, such as Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome
- High blood pressure
- Smoking (leading to injury of the wall of the aorta)
- Atherosclerosis (hardening of the arteries)
- Bicuspid aortic valve, a congenital heart condition
- Infections affecting the aorta
- Trauma or injury to the aorta
Aortic root aneurysms often have no symptoms. Some possible aneurysm symptoms are:
- Dull chest pain
- Chest pain during exercise
- Shortness of breath
Symptoms of a dissected or ruptured aortic root aneurysm include:
- Sharp chest pain, sometimes also felt in the back.
- Extreme shortness of breath
- Trouble swallowing
- Fainting/loss of consciousness
Aortic root aneurysms are typically diagnosed using the following imaging tests:
- Echocardiogram (ultrasound of the heart): An echocardiogram uses sound waves to create a picture of the heart and blood vessels. It is the most common test used to diagnose aortic root aneurysms.
- Computed tomography (CT) scans use X-rays and computer technology to produce detailed images of the aorta.
- Magnetic resonance imaging (MRI) scans use a powerful magnetic field and radio waves to produce detailed images of the aorta.
Aortic root replacement and valve surgery – also called the Bentall procedure – replaces the aortic root plus the aortic valve. It is for patients who have an aortic root aneurysm or dissection plus aortic valve problems. This can be helpful for patients with aortic valve regurgitation (leaky valve) or calcification (hardening). The surgeon removes part of the aorta and the aortic valve, then replaces the missing section of the aorta with an artificial tube, called a graft. The aortic valve is replaced with a mechanical or biological valve. Patients with mechanical valve must take blood-thinning medications for the rest of their lives to prevent blood clots from forming.
Valve-sparing aortic root replacement is a good choice if your aortic valve is working well. This procedure replaces your aortic root, but not your aortic valve. The Yacoub procedure involves remodeling the aortic valve. The David procedure involves reimplantation of your aortic valve. By keeping one's own valve, there is no need to take blood thinning medications for life.
Medical management of aortic root aneurysms involves regular monitoring of the aneurysm’s size and shape and taking steps to prevent it from growing or rupturing. Monitoring typically involves regular imaging tests, such as CT scans or ultrasound, to track the size and shape of the aneurysm. The frequency of these tests will be determined by your doctor based on the size and rate of growth of the aneurysm.
Medical management of an aortic root aneurysm also involves managing underlying health conditions, such as high blood pressure or smoking, that can contribute to aneurysm growth. If appropriate, your healthcare provider may prescribe medications such as beta-blockers or angiotensin receptor blockers. It is essential to modify your risk for rupture by controlling high cholesterol and high blood pressure, and avoiding tobacco use. In some cases, surgical intervention may be necessary to repair or remove the aneurysm.
It is important to follow your provider’s recommendations and attend all scheduled appointments and tests to ensure proper monitoring and management of an aortic root aneurysm.
Certified genetic counselors are healthcare professionals with specialized training in genetics and counseling. They are available to discuss the potential role of genetics in the development of aortic aneurysms. The genetic counselor will review your personal and family medical history and may perform genetic testing to identify any potential genetic mutations that increase the risk of developing aortic aneurysms. If a mutation is found, the genetic counselor will discuss the implications for you and your family members, including the risks of inheriting the condition and the potential for future generations to be affected. They will also provide information about available screening and monitoring options and the importance of regular check-ups.
Genetic counselors work with you and your family to discuss:
- The inheritance pattern, including the role of genetic and environmental factors.
- The potential risks for the individual and their family members, including the likelihood of developing the condition and the potential impact on their health and daily life.
- The available genetic testing options, including the benefits, limitations, and results of genetic testing for a thoracic aortic aneurysm.
- The management options for an aortic aneurysm, including medical, surgical, and lifestyle interventions.
- The psychological and emotional impact of an aortic aneurysm and the importance of support and resources for individuals and families affected by the condition.
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To schedule an appointment to discuss an aortic aneurysm or any other cardiovascular condition, call us at 888-287-1082 or visit our Make a Cardiovascular Appointment page, where you may view other information about scheduling a cardiovascular appointment.