A thoracic aortic aneurysm is a dilatation of the wall of the aorta in the chest due to a weakening of the aortic wall. This can be fatal if the aneurysm ruptures.
You may not feel any symptoms with a TAA. Only half of patients with TAA notice symptoms.
If you do have symptoms, they will depend on where your aneurysm is located and how large it is. Possible symptoms include:
- Pain in the jaw, neck, and upper back
- Chest or back pain
- Coughing, hoarseness, or difficulty breathing
It is critical to notify your physician immediately if you experience any symptoms of TAA. If left untreated, these conditions may lead to a fatal rupture or organ damage. This is a life-threatening situation and you should seek medical attention immediately.
Your physician will order one or more of the following tests to diagnose TAA:
"Watchful Waiting"
If your TAA is small and not causing symptoms, your physician may recommend "watchful waiting,” which means that you will be monitored every 6 months for signs of changes in your aneurysm. Your physician may schedule you for CT or MRI scans every 6 months to watch the aneurysm. This test can help your physician monitor the size and shape of your aneurysm. This method is usually used for aneurysms that are smaller than about 5 centimeters across.
However, if your TAA is large or causing symptoms, your vascular surgeon may recommend actively treating your aneurysm especially if it grows quickly, or you have certain other types of disease. For example, if you have Marfan's syndrome, you may require treatment sooner than patients who have small TAAs but do not have Marfan's syndrome. The treatments for TAA are open surgical aneurysm repair and endovascular stent-graft repair.
During open aneurysm repair, your surgeon makes an incision in your chest and replaces the weakened portion of your aorta with a fabric tube, called a graft. The graft is stronger than the weakened aorta and allows blood to pass through it without causing a bulge.
Following the surgery, you may stay in the hospital for 7 to 10 days. If your aneurysm is extensive or complex, or if you have other conditions such as heart, lung or kidney disease, you may require 2 to 3 months for a complete recovery.
Instead of open aneurysm repair, if your aneurysm location and shape is suitable, your vascular surgeon may consider a promising, newer procedure called an endovascular stent graft. Endovascular means that the treatment is performed inside your body using long, thin tubes called catheters. During the procedure, your surgeon will use live x-ray pictures viewed on a video screen to guide a stent-graft to the site of your aneurysm. Like the graft used in open surgery, this stent-graft allows blood to flow through your aorta without putting pressure on the damaged wall of your aneurysm. This keeps your aneurysm from rupturing. Endovascular stent-graft repair requires a shorter recovery time than open aneurysm repair, and your hospital stay is reduced to 2 of 3 days. However, this treatment may not be applicable to all TAAs, since your aneurysm must have a suitable shape to allow the stent-graft to be used effectively.
Your vascular surgeon will advise you regarding the best option for your particular situation.
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UT-Vascular & Endovascular Surgery 
