Aortic aneurysms & dissections

The aorta is the main blood vessel, or artery, that sends blood from your heart to the rest of your body. A healthy aorta is a tube that’s about one inch wide. When an aneurysm forms, a section of the aorta bulges out all around making its walls weaker and thinner.

A dissection of the aorta forms when the inner layer of the wall of the aorta develops a tear. This creates an area between the inner and outer layers that fills with blood and puts extra pressure on the outer layer of the aorta’s wall.

Either of these conditions may make the aorta burst – which can be life-threatening.

At Advocate Heart Institute, our surgeons, cardiologists and other specialists have experience managing all kinds of aortic aneurysms and dissections.

Types of aortic aneurysms & dissections

Aortic aneurysms and dissections are classified by their location. When your health care team talks to you, they may use these names to describe your condition. They’ll also explain the severity of your aneurysm or dissection and what kind of treatment they recommend based on your individual health and condition.

The types of aneurysms include:

• Thoracic aneurysm – located in the chest
• Abdominal aneurysm – located in the abdomen
• Thoracoabdominal aneurysm – spans the chest and abdomen

Classification of dissections is as follows:

• Type A dissection – located in the chest
• Type B dissection – located in the abdomen

Symptoms of aortic aneurysms & dissections

Many people with aortic aneurysms and dissections are unaware of their condition. Often, the first sign is rupture, accompanied by sudden, severe pain. Depending on the location of the rupture, the pain may occur at any place along the aorta. It may be a sharp, sudden pain in the chest or upper back, or throbbing or deep pain in the back or side.

Other symptoms may include:

• Shortness of breath
• Nausea and vomiting
• Sudden weakness
• Fainting

Causes of aortic aneurysms and dissections

Unhealthy behaviors, diseases or genetics can cause aortic aneurysms and dissections. Some risk factors include:

• Smoking
• High blood pressure
• High cholesterol or atherosclerosis (buildup of plaque in the arteries)
• Trauma, such as car crashes
• Certain inherited genes and connective tissue disorders, such as Marfan syndrome
• Family history of aortic aneurysms

Preventing aortic aneurysms & dissections

The best way to prevent aortic aneurysms and dissections is a healthy lifestyle. You can reduce your risk by:

• Controlling high blood pressure and cholesterol levels
• Eating healthy
• Exercising routinely
• Maintaining a healthy weight
• Quitting smoking

Doctors may detect an aortic aneurysm or dissection incidentally during a routine physical exam, X-ray or ultrasound test.

People with family histories of aneurysm or dissection or other inherited conditions may receive an early diagnosis. Early detection is essential and allows us to monitor and treat you before a rupture occurs.

Risk reduction scans for smoking

Because abdominal aneurysms are more common, we recommend abdominal ultrasound screening for all men ages 65 to 75 who have ever smoked. Talk to your primary care provider about this important test.

Diagnosing aortic aneurysms & dissections

We identify aneurysms and dissections using standard cardiovascular diagnostic tools, including a thorough health history, family history and physical exam. Though we may use basic X-rays, we generally obtain more detailed images using:

• Echocardiography (heart ultrasound)
• Cardiac CT
• Cardiac MRI

Treating aortic aneurysm and dissection

Although aortic aneurysms and dissections are rare, our experience with them is extensive. Physicians and cardiologists within Advocate Health Care and beyond refer their patients to us because of our expertise and excellent outcomes.

The treatments we use for aortic aneurysms and dissections include:

Surveillance for thoracic aortic aneurysm

People with aortic aneurysms and dissections may not need immediate treatment. Close monitoring by our surveillance clinic may be more appropriate. If we recommend monitoring for you, we’ll make appointments for you to come in to be checked at regular intervals.

Our surveillance clinic also monitors people after they’ve had surgery.

Your follow-up testing will be reviewed and compared to your prior results. In some cases, we’ll follow up with a phone call and no repeat testing unless you ask for it. If testing reveals a problem, you’ll see your doctor to discuss what comes next.

Endovascular aortic repair

These are minimally invasive procedures that use stents to reinforce damaged areas of your arteries. Stents are metal mesh tubes covered by fabric. A specialist inserts them through a small incision in your groin using a special scope with a tiny camera that lets them guide the stent to the right place.

Open aortic surgery

We use open surgeries in complex cases to provide direct access to the affected part of your aorta. An open approach might be best if your aneurysm or dissection is located in:

• The part of the aorta, which contains the aortic valve. In this case, the surgeon will fix the section of the aorta and repair the valve. Valve repair is a better long-term choice than replacement.
• An area of your aorta where other arteries branch off. We may need to use open procedures to reconstruct these connections.

Hybrid approaches

A hybrid method for treating an aortic aneurysm or dissection involves both open surgery and endovascular techniques. We'll individualize our hybrid approach based on your condition and overall health. These complex treatments require coordinated teams of skilled surgeons and specialists. You’ll find such experts throughout Advocate Heart Institute.

Follow-up care

We provide ongoing care with a well-developed system for continuing care for people who have aneurysms and dissections. This follow-up is especially important for aortic dissections because they increase your risk for future problems.

We also coordinate genetic testing for you and your family, as needed, to help determine if they also have an aortic disease.