The aorta is the main blood vessel running just in front of the vertebral column from the heart to the body. The thoracic aorta carries all the blood from the heart to the abdominal organs (kidneys, liver and spleen and intestine) and the legs.
The thoracic aorta can develop several diseases which need treatment. These include dissection, aneurysm and penetrating ulceration.
An aneurysm is an abnormal dilation of the aorta. There are multiple causes of aneurysms including male sex, age, hypertension, smoking, family history, infection and other disease. It may initially seem that dilation would simply allow more blood to flow. However, there are two problems which result from this. As the aorta dilates, the wall becomes thinner and therefore weaker. This means that eventually the wall will rupture which is a critical life threatening event which can happen without warning. The other main problem occurs because dilation of the vessel slows the flow increasing the risk of thrombus formation which cause be swept into the major branches causing severe problems. Mild dilation of the aorta is not uncommon, but the risk of complications rises steeply as the aneurysm enlarges further. Small aneurysms are usually carefully monitored, but larger aneurysms (generally about 5 - 6 cm in diameter) generally need treatment. Fortunately, thoracic aneurysms are less common than other types of aneurysms.
If you have a known Thoracic Aortic Aneurysm and develop sudden back or abdominal pain you should present to your nearest emergency department.
A thoracic aortic dissection is a condition in which the different layers of the aortic wall is made up of split forming a false channel which can obstruct flow and cause aneurysms. It can be a life threatening condition. It is usually associated with connective tissue disease or untreated hypertension. Some dissections are treated with medication, while others need intervention.
A thoracic aortic penetrating ulcer is a condition in which the blood flow begins to erode into the inner layers of the wall. It can be a precursor to dissection or rupture.
Thoracic Aortic pathologies can be complex or relatively straight forward. Those requiring open surgery are usually performed in a major public hospital. More straight forward aneurysms can be treated with minimally invasive techniques using a stent graft (TEVAR) in an angiography suite.