A thoracic aortic aneurysm is an aneurysm in the part of the aorta in the chest that is situated above the diaphragm, a muscle that helps you breathe. Approximately 25 percent of aortic aneurysms are thoracic, the rest are in the abdomen. Thoracic aortic aneurysms are serious. They can rupture and lead to severe internal bleeding and result in death.
These do not always cause symptoms, even when they're large. Only half of all people who have thoracic aortic aneurysms notice any symptoms. Aneurysms can appear in any of three sections of the thoracic aorta:
- Ascending aorta, which emerges from the left ventricle
- Aortic arch, the part of the aorta that arches and turns downward before it becomes the descending aorta
- Descending aorta, which branches into the thoracic and abdominal aorta
Not all patients with ascending, arch, or descending aneurysms require immediate surgical treatment. Using a collaborative approach to care, our surgeons and cardiologists will monitor the progression of these aneurysms until surgery is determined to be necessary.
Patients with extensive aortic disease may require a hybrid approach, a combination of open surgery and endovascular repair.
Ascending and arch aneurysms sometimes require complex surgical treatment, including the use of hypothermic circulatory arrest (HCA), a technique that utilizes very cold body temperatures to temporarily stop blood flow to the area of the aorta being operated on. We have a variety of open surgical options for the repair of descending aortic aneurysms.
Endovascular treatment (surgery that is performed inside the aorta using catheters) has emerged as a true alternative to open-heart surgery, and a life-saving option for those patients who are not good candidates for open-heart surgery. The University of Michigan Frankel Cardiovascular Center is an early pioneer in this minimally invasive approach and we have extensive experience treating high-risk patients with favorable outcomes.
For instance, with high-risk patients with arch aneurysms, a less invasive “debranching” option bypasses arch vessels and eliminates the need for the hypothermic circulatory arrest mentioned above.
Similarly, patients with thoracoabdominal aneurysms (aneurysms that coexist in both the chest and the abdomen) may also be candidates for the debranching option, which also eliminates the need for a large thoracoabdominal incision.
For many patients with thoracic aortic aneurysms, thoracic endovascular aortic repair (TEVAR) has emerged as a solid alternative to conventional open-heart surgery. This minimally invasive endovascular option for some patients who are not optimal candidates for traditional open repair can shorten hospital stays and reduce recovery periods. Visit our TEVAR page for more information about this minimally invasive option.
Thoracic Aortic Disease Treatment at the University of Michigan
The Thoracic Aortic Program at the University of Michigan is the most experienced in the state, and one of the largest in the country. Our documented outcomes include some of the lowest mortality rates for even the most complex thoracic aortic reconstructions. We are also one of a few centers that offer descending thoracic aortic repair and maintain very favorable outcomes despite the complexity of the procedure.
Research Brings New Treatment Options for Aortic Disease
We continue to forge the way, discovering new innovative and improved treatment options for aortic diseases. The University of Michigan is home to the International Registry of Aortic Dissection, and several research laboratories that are exploring the molecular etiologies of aortic diseases. Through patient participation and research, we are helping to advance the best treatment options for all types of aortic diseases.
Make an Appointment
To make an appointment to discuss your need for aortic treatment, call the University of Michigan Frankel Cardiovascular Center toll-free at 888-287-1082 or email us at CVCCallCtr@med.umich.edu. Visit our Make an Appointment page for more information about what to expect when you call us.