The word "aneurysm' means out-pouching or bulging of a portion of a blood vessel that can occur anywhere in the body. When an aneurysm occurs in the aorta, the largest blood vessel in the body, it is either a thoracic aneurysm, located the chest, or an abdominal aneurysm. The elastic fibre in the vessel wall can undergo damage and become weak. This causes the wall to bulge resulting in an aneurysm. The size continues to increase because of the blood pressure and when it reaches a critical size ruptures just like blowing too much air into a balloon.. This can be a life-threatening emergency. The goal of surgery is to intervene before that happens by removing the dilated portion of the vessel and replacing it with a graft a tube of synthetic material, that won't rupture or tear.
What causes an aortic aneurysm?
- Atherosclerosis (Cholesterol deposition in the wall of the arteries)
- Chronic or untreated high blood pressure
- Smoking
- Injury (for example, a car accident)
- Congenital abnormality (present from birth)
- Inherited conditions (for example, Marfan syndrome,These are all conditions that have the potential to weaken the wall of the vessel, allowing it to dilate or balloon out over time.
What are the symptoms of an aortic
Aortic Aneurysms usually do not cause symptoms until they get quite large. They often are found during an examination for a different medical condition. When they are large enough to cause symptoms, people may notice pulsating mass in the abdomen, chest or abdominal pain, back pain, palpitations, fatigue, dizziness or shortness of breath.Sudden severe abdominal or back pain that feels like the worst pain anyone has ever had is usually a sign of a tear or rupture and is an extreme medical emergency.
How are aortic aneurysms discovered or diagnosed?
Large aneurysms can be seen on a chest or abdominal x-ray. They are also detected by studies such as routine ultra sound abdomen, CT scan, MRI, or echocardiography. These studies also help to determine the exact location and size of the aneurysm. When a small aneurysm is found, the study used to find it is repeated on a regular basis, usually every six to 12 months, to monitor any change in size. This helps determine the ideal time for surgical intervention.
Surgery is usually advised if the aneurysm is
- Larger than 5.5cm
- Growing by more than 1cm per year
- Causing pain
How is the aneurysm fixed?
Surgical repair involves removal of the diseased portion of the aorta. Clamps are placed above and below the aneurysm, which is then cut out and removed. A fabric tube, or graft, is sewn onto both cut ends to replace the diseased portion that is removed.
Minimally Invasive Surgery for Aortic Aneurysms
There is another technique for repairing an aortic aneurysm that can be used for patients who are at too high of a risk to undergo major surgery. This involves placing a device called a "stent graft" inside the diseased portion of the aorta without opening the abdomen or chest. The stent is placed inside the aorta through a catheter that is put through an artery leading to the aorta usually from the groin. This stent graft can relieve most of the pressure of blood flowing through the aneurysm, preventing rupture.