MEANING:
An aortic aneurysm is a general term for any swelling (dilatation or aneurysm) of the aorta, usually representing an underlying weakness in the wall of the aorta at that location. While the stretched vessel may occasionally cause discomfort, a greater concern is the risk of rupture, which causes severe pain; massive internal hemorrhage; and, without prompt treatment, results in a quick death.
Classification:
Aortic aneurysms are classified by where on the aorta they occur; aneurysms can appear anywhere.
#An aortic root aneurysm, or aneurysm of sinus of Valsalva, appears on the sinuses of Valsalva or aortic root.
#Thoracic aortic aneurysms are found on the thoracic aorta; these are further classified as ascending, aortic arch, or descending aneurysms depending on the location on the thoracic aorta involved.
#Abdominal aortic aneurysms, the most common form of aortic aneurysm, are found on the abdominal aorta, and thoracoabdominal aortic aneurysms involve both the thoracic and abdominal aorta. There are other classifications that might help treatment.
Treatment :
If the aneurysm is small and there are no symptoms (for example, if it was discovered during a routine physical), your doctor may recommend periodic evaluation. This usually includes a yearly ultrasound, to see if the aneurysm is getting bigger.
Aneurysms that cause symptoms usually require surgery to prevent complications.
Surgery is recommended for patients with aneurysms bigger than 5.5 cm in diameter and aneurysms that rapidly increase in size. The goal is to perform surgery before complications or symptoms develop.
There are two approaches to surgery:
#In a traditional (open) repair, a large cut is made in your abdomen. The abnormal vessel is replaced with a graft made of synthetic material, such as Dacron.
#The other approach is called endovascular stent grafting. An endovascular stent graft is a tube made of metal mesh that helps support the artery. Small, hollow tubes called catheters are inserted through arteries in your groin. The stent graft is sent through a catheter, and permanently placed into the artery. Endovascular stent grafting can be done without making a large cut in your abdomen, so you may get well faster. However, not all patients with abdominal aortic aneurysms can have this type of surgery.
Symptoms :
Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly.
Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly.
The symptoms of rupture include:
*Nausea and vomiting
*Pain in the abdomen or back -- severe, sudden, persistent, or constant. The pain may radiate to groin, buttocks, or legs.
*Pulsating sensation in the abdomen
*Rapid heart rate when rising to a standing position
AORTIC DISSECTION:
Aortic dissection is a tear in the wall of the aorta that causes blood to flow between the layers of the wall of the aorta and force the layers apart. Aortic dissection is a medical emergency and can quickly lead to death, even with optimal treatment. If the dissection tears the aorta completely open (through all three layers), massive and rapid blood loss occurs. Aortic dissections resulting in rupture have an 80% mortality rate, and 50% of patients die before they even reach the hospital. If the dissection reaches 6 cm, the patient must be taken for emergency surgery.
