The thoracic aorta lies within the chest and is the main blood vessel in the body. Along with all the other major arteries in the body it is susceptible to dilation or aneurysm formation. An aneurysm is a dilation in the blood vessel to greater than 1.5 times its normal size.
As with other aneurysms the main risk factors include:
Smoking
Hypertension
Hypercholesterolaemia
Type 2 diabetes
Most aneurysms are detected incidentally when investigating for other symptoms or are discovered when performing screening following the diagnosis of an abdominal aortic aneurysm. However some patients require ongoing monitoring following damage to the aorta from trauma or a dissection.
Other diseases of the thoracic aorta include:
Dissection
This is a longitudinal tear in the middle layer of tissue that forms the aortic wall. It usually presents with a tearing chest pain and can have significant complications if not treated immediately. If you experience symptoms like this it is best to call 000 for an ambulance.
Congenital
There are several congenital diseases of the thoracic aorta, they include coarctation, aberrant right subclavian artery, situs inversus and right sided aorta. Not all of these conditions require treatment and some are suitable for monitoring.
Management
As there are significant risks associated with thoracic aortic surgery treatment for these pathologies requires careful planning and assessment. Once the thoracic aortic disease is discovered further assessment a CT scan will be required. Commonly sound medical management with aspirin, cholesterol reducing medication and blood pressure control is implemented.
Depending on the type of pathology further testing may be required to assess your suitability for treatment. Most pathology of the descending aorta is able to be treated with a stent graft called a TEVAR (thoracic endovascular aortic repair) using key hole methods. Occasionally this is done in combination with open bypass surgery or in some cases open repair is recommended due to the type and location of the disease.
Consultation
During your initial consultation with Dr McGlade he will take a through history and examination. After a careful review of your scans and other medical history he will formulate a treatment plan tailored to yourself and your disease. This may include monitoring, further investigation or booking for surgery.
During the consultation you will have time to ask any questions you have about your pathology and the most effective treatment. Most thoracic aortic pathology Dr McGlade will treat via key hole or endovascular means. This however may have to be combined with a bypass procedure but this will be discussed with you during your consultation.
