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Aortic Arch Dilatation / Ascending Aorta Dilatation (Thoracic)

Condition

Widening of the thoracic portion of the aorta

What is a thoracic Aortic arch dilatation/ascending Aorta dilatation?

The aorta, the main artery in the body, starting directly from the heart within the chest, is called Thoracic Aorta and is divided in the ascending portion, the aortic arch (the arch curving into the descending part, from which the arteries of the brain and the arms are initiating), and the descending thoracic part, which is continuing downwards towards the abdominal area.

Aortic arch dilatation (thoracic) condit

What causes Aortic arch dilatation/ascending Aorta dilatation?

The cause is similar to the abdominal aortic aneurysm, genetic vascular wall weakness and elevated blood pressure being the major risk factors and rarely nowadays inflammatory disease or syphilis. 

 

Thoracic aortic aneurysms run in some families for no apparent reason; this represents about 20% of all cases. These aneurysms are also linked to known genetic syndromes, most commonly to Marfan Syndrome but also to Ehlers-Danlos Syndrome, Loeys-Dietz Syndrome and Turner Syndrome.  

 

Your risk is higher if you have one of those genetic syndromes as you age, or if you smoke or have high blood pressure. The ascending aorta portion is of special interest because of its proximity to the aortic valve of the heart. This portion can be seen and monitored in transthoracic Echocardiography (=TTE). 

What are the symptoms of Aortic arch dilatation/ascending Aorta dilatation?

Often there are no symptoms. Symptoms include:

  • As a thoracic aortic aneurysm grows, some people may notice:

  • Tenderness or pain in the chest.

  • Back pain; pain between the shoulder blades

  • Hoarseness.

  • Cough

  • Shortness of breath

When they dissect or rupture you may notice: 

  • Excruciating pain in the chest or back pain between the shoulder blade

  • Shortness of breath

  • Heart failure: shock-like symptoms, cold sweats, loss of consciousness, which are a sign of acute rupture/inner vessel wall rupture (dissection) and requires immediate medical attention.

What imaging/tests are done to diagnose Aortic arch dilatation/ascending Aorta dilatation?

  • Transthoracic Echocardiography (TTE)

  • Transesophageal Echocardiography (TEE)

  • Angio-Computer Tomography = Angio-CT scan

  • Angio-Magnet Resonance Tomography = Angio-MRI

What intervention/treatment can be performed for Aortic arch dilatation/ascending Aorta dilatation and when?

Asymptomatic patients with thoracic aneurysms for whom the ascending aorta diameter is reaching 5.5 cm or less, should be followed-up closely. A diameter of more than 5.5cm or an increase of more than 3mm per year should undergo surgical repair. 

 

Most aneurysms grow slowly at a rate of about 3mm (1/8th inch) per year, but larger aneurysms can grow more quickly. How often you will need a follow up investigation depends on the size of your aneurysm.

What intervention/treatment does CardioCare offer for Aortic arch/ascending Aorta  dilatation?

We work closely with international experienced cardiothoracic surgeons who will perform the surgical repair of the ascending aorta dilatation. Once the patient has left the critical care unit we will continue the postoperative and rehabilitation care.

 

At CardioCare we do offer close revisions with transthoracic or transesophageal Echocardiography and also post-operative follow-up and care.

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