Aneurysm Thoracic Aortic | The Common Vein

Thoracic Aortic Aneurysm

Ashley Davidoff MD

Aortic aneurysym is a condition characterized by a bulging of the aortic wall and associated symptoms. 2-5% of aneurysms occur in the thoracic aorta

Cause

Caused by arteriosclerosis, aortic trauma, aortic inflammation, heredity, and syphilis. atherosclerosis destroys medial elements

Pathogenesis

atherosclerosis causes weakening of wall aorta dilates tension increases acceleration of the process Laplace’s Law: tension is proportional to the product of pressure and radius)

Result

Dilation can occur anywhere along the thoracic aorta Most common sites are the arch and descending aorta

Natural History

Five year survival in one study was 27% for symptomatic and 58% for asymptomatic thoracic aneurysms

Complications

Rupture of an aneurysm is heralded by the dramatic onset of excruciating pain Aneurysms greater than 7 cm are more prone to rupture than smaller ones and symptomatic ones are more prone to rupture than asymptomatic ones

Diagnosis

Clinical

Symptoms are secondary to impingement on adjacent structures Tracheal deviation , stridor, hemoptysis, dyspnea, pneumonitis from compression of the tracheobronchial tree, hoarseness from compression of the laryngeal nerve, dysphagia from esophageal compression, SVC syndrome, and pain is due to compression and erosion on musculoskeletal structures and is usually steady and may be severe

Imaging

Treatment

Elective resection is recommended for thoracic aneurysms greater than 6 and in some institutions 7 cm in diameter, 2 times normal diameter, or if symptomatic Major operative complications include paraplegia from inadvertent interruption of the spinal cord’s arterial blood supply (5%) and those secondary to associated arteriosclerosis (MI, CVA, renal failure, etc.)

Bental Procedure for Ascending Aorta
Persistent Descending Thoracic Aneurysm
61 year old female post op repair of ascending aortic aneurysm with Bental procedure with dropping blood pressure and odecreasing oxygen saturation aorta left atrium LA heart cardiac mediastinum fx compression of left atrium from anterior post operative mediastinal hematoma and posterior aneurysm of the descending aorta
fx lingula atelectasis and left lower lobe atelectasis bilateral pleural effusions dx supravalvular mitral stenosis CTscan
Ashley Davidoff MD TheCommonVein.net 47752

DOMElement Object
(
    [schemaTypeInfo] => 
    [tagName] => table
    [firstElementChild] => (object value omitted)
    [lastElementChild] => (object value omitted)
    [childElementCount] => 1
    [previousElementSibling] => 
    [nextElementSibling] => (object value omitted)
    [nodeName] => table
    [nodeValue] => 



Thoracic Aortic Aneurysm
The Common Vein Copyright 2007
Ashley Davidoff MD
Aortic aneurysym is a condition characterized by a bulging of the aortic wall and associated symptoms. 2-5% of aneurysms occur in the thoracic aorta
Cause
Caused by arteriosclerosis, aortic trauma, aortic inflammation, heredity, and syphilis. atherosclerosis destroys medial elements
Pathogenesis
atherosclerosis causes weakening of wall aorta dilates tension increases acceleration of the process Laplace’s Law: tension is proportional to the product of pressure and radius)
Result
Dilation can occur anywhere along the thoracic aorta Most common sites are the arch and descending aorta
Natural History
Five year survival in one study was 27% for symptomatic and 58% for asymptomatic thoracic aneurysms
Complications
Rupture of an aneurysm is heralded by the dramatic onset of excruciating pain Aneurysms greater than 7 cm are more prone to rupture than smaller ones and symptomatic ones are more prone to rupture than asymptomatic ones
Diagnosis
Clinical
Symptoms are secondary to impingement on adjacent structures Tracheal deviation , stridor, hemoptysis, dyspnea, pneumonitis from compression of the tracheobronchial tree, hoarseness from compression of the laryngeal nerve, dysphagia from esophageal compression, SVC syndrome, and pain is due to compression and erosion on musculoskeletal structures and is usually steady and may be severe
Imaging
Treatment
Elective resection is recommended for thoracic aneurysms greater than 6 and in some institutions 7 cm in diameter, 2 times normal diameter, or if symptomatic Major operative complications include paraplegia from inadvertent interruption of the spinal cord’s arterial blood supply (5%) and those secondary to associated arteriosclerosis (MI, CVA, renal failure, etc.)



    [nodeType] => 1
    [parentNode] => (object value omitted)
    [childNodes] => (object value omitted)
    [firstChild] => (object value omitted)
    [lastChild] => (object value omitted)
    [previousSibling] => 
    [nextSibling] => (object value omitted)
    [attributes] => (object value omitted)
    [ownerDocument] => (object value omitted)
    [namespaceURI] => 
    [prefix] => 
    [localName] => table
    [baseURI] => 
    [textContent] => 



Thoracic Aortic Aneurysm
The Common Vein Copyright 2007
Ashley Davidoff MD
Aortic aneurysym is a condition characterized by a bulging of the aortic wall and associated symptoms. 2-5% of aneurysms occur in the thoracic aorta
Cause
Caused by arteriosclerosis, aortic trauma, aortic inflammation, heredity, and syphilis. atherosclerosis destroys medial elements
Pathogenesis
atherosclerosis causes weakening of wall aorta dilates tension increases acceleration of the process Laplace’s Law: tension is proportional to the product of pressure and radius)
Result
Dilation can occur anywhere along the thoracic aorta Most common sites are the arch and descending aorta
Natural History
Five year survival in one study was 27% for symptomatic and 58% for asymptomatic thoracic aneurysms
Complications
Rupture of an aneurysm is heralded by the dramatic onset of excruciating pain Aneurysms greater than 7 cm are more prone to rupture than smaller ones and symptomatic ones are more prone to rupture than asymptomatic ones
Diagnosis
Clinical
Symptoms are secondary to impingement on adjacent structures Tracheal deviation , stridor, hemoptysis, dyspnea, pneumonitis from compression of the tracheobronchial tree, hoarseness from compression of the laryngeal nerve, dysphagia from esophageal compression, SVC syndrome, and pain is due to compression and erosion on musculoskeletal structures and is usually steady and may be severe
Imaging
Treatment
Elective resection is recommended for thoracic aneurysms greater than 6 and in some institutions 7 cm in diameter, 2 times normal diameter, or if symptomatic Major operative complications include paraplegia from inadvertent interruption of the spinal cord’s arterial blood supply (5%) and those secondary to associated arteriosclerosis (MI, CVA, renal failure, etc.)



)

DOMElement Object
(
    [schemaTypeInfo] => 
    [tagName] => td
    [firstElementChild] => (object value omitted)
    [lastElementChild] => (object value omitted)
    [childElementCount] => 20
    [previousElementSibling] => 
    [nextElementSibling] => 
    [nodeName] => td
    [nodeValue] => 
Thoracic Aortic Aneurysm
The Common Vein Copyright 2007
Ashley Davidoff MD
Aortic aneurysym is a condition characterized by a bulging of the aortic wall and associated symptoms. 2-5% of aneurysms occur in the thoracic aorta
Cause
Caused by arteriosclerosis, aortic trauma, aortic inflammation, heredity, and syphilis. atherosclerosis destroys medial elements
Pathogenesis
atherosclerosis causes weakening of wall aorta dilates tension increases acceleration of the process Laplace’s Law: tension is proportional to the product of pressure and radius)
Result
Dilation can occur anywhere along the thoracic aorta Most common sites are the arch and descending aorta
Natural History
Five year survival in one study was 27% for symptomatic and 58% for asymptomatic thoracic aneurysms
Complications
Rupture of an aneurysm is heralded by the dramatic onset of excruciating pain Aneurysms greater than 7 cm are more prone to rupture than smaller ones and symptomatic ones are more prone to rupture than asymptomatic ones
Diagnosis
Clinical
Symptoms are secondary to impingement on adjacent structures Tracheal deviation , stridor, hemoptysis, dyspnea, pneumonitis from compression of the tracheobronchial tree, hoarseness from compression of the laryngeal nerve, dysphagia from esophageal compression, SVC syndrome, and pain is due to compression and erosion on musculoskeletal structures and is usually steady and may be severe
Imaging
Treatment
Elective resection is recommended for thoracic aneurysms greater than 6 and in some institutions 7 cm in diameter, 2 times normal diameter, or if symptomatic Major operative complications include paraplegia from inadvertent interruption of the spinal cord’s arterial blood supply (5%) and those secondary to associated arteriosclerosis (MI, CVA, renal failure, etc.)
    [nodeType] => 1
    [parentNode] => (object value omitted)
    [childNodes] => (object value omitted)
    [firstChild] => (object value omitted)
    [lastChild] => (object value omitted)
    [previousSibling] => (object value omitted)
    [nextSibling] => (object value omitted)
    [attributes] => (object value omitted)
    [ownerDocument] => (object value omitted)
    [namespaceURI] => 
    [prefix] => 
    [localName] => td
    [baseURI] => 
    [textContent] => 
Thoracic Aortic Aneurysm
The Common Vein Copyright 2007
Ashley Davidoff MD
Aortic aneurysym is a condition characterized by a bulging of the aortic wall and associated symptoms. 2-5% of aneurysms occur in the thoracic aorta
Cause
Caused by arteriosclerosis, aortic trauma, aortic inflammation, heredity, and syphilis. atherosclerosis destroys medial elements
Pathogenesis
atherosclerosis causes weakening of wall aorta dilates tension increases acceleration of the process Laplace’s Law: tension is proportional to the product of pressure and radius)
Result
Dilation can occur anywhere along the thoracic aorta Most common sites are the arch and descending aorta
Natural History
Five year survival in one study was 27% for symptomatic and 58% for asymptomatic thoracic aneurysms
Complications
Rupture of an aneurysm is heralded by the dramatic onset of excruciating pain Aneurysms greater than 7 cm are more prone to rupture than smaller ones and symptomatic ones are more prone to rupture than asymptomatic ones
Diagnosis
Clinical
Symptoms are secondary to impingement on adjacent structures Tracheal deviation , stridor, hemoptysis, dyspnea, pneumonitis from compression of the tracheobronchial tree, hoarseness from compression of the laryngeal nerve, dysphagia from esophageal compression, SVC syndrome, and pain is due to compression and erosion on musculoskeletal structures and is usually steady and may be severe
Imaging
Treatment
Elective resection is recommended for thoracic aneurysms greater than 6 and in some institutions 7 cm in diameter, 2 times normal diameter, or if symptomatic Major operative complications include paraplegia from inadvertent interruption of the spinal cord’s arterial blood supply (5%) and those secondary to associated arteriosclerosis (MI, CVA, renal failure, etc.)
)

TCV