When is surgery recommended for an enlarged aorta or aortic aneurysm?
For aneurysms less than 5 cm, the risk of aortic catastrophe is approximately 4-6% per year. When the aneurysm grows to 5 - 6 cm, the annual risk increases to as much as 12% per year, and at 7 cm it exceeds 25% per year. Given these risks, surgery is usually recommended for patients with aneurysms 5.0 - 5.5 cm in diameter.
However, this threshold may vary depending on other patients factors. Specific treatment will be determined by your physician based on: age, overall health and medical history, size and extent of the disease, signs and symptoms, tolerance of specific medications, procedures or therapies, expectations for the course of the disease, and patient preferences.Surgery is recommended for patients with smaller aneurysms if they have symptoms related to the aneurysm, other heart disease requiring surgery, a bicuspid aortic valve, strong family history, and/or connective tissue disease such as Marfan's or Lowy Dietz.
IndicationSymptoms
Evidence of Dissection Increase in size > 0.5 cm/yr Concomitant Heart Surgery
Primary disease of aortic root or ascending aorta (with risk factors including family history of aortic disease or connective tissue disease) Primary disease of aortic root or ascending aorta (without risk factors) Primary disease of aortic arch or descending aorta (without risk factors) |
Aortic Size (cm)any
any any > 4 - 4.5 cm > 4.5 - 5.0 cm > 5 - 5.5 cm > 5.5 - 6 cm |
Aortic disease is often insidious. Most people with aortic aneurysms experience no symptoms, unless they are extremely large or an aortic dissection occurs. For most people, their aortic condition is discovered incidentally while being tested for other reasons.
Surgery is recommended in order to prevent an aortic catastrophe, including aortic rupture or aortic dissection. An aortic rupture is typically a fatal event. An aortic dissection is associated with a high rate of death as well as other serious complications including heart attack, stroke, and paralysis. The risk of these events increases with aortic size.
Surgery is recommended in order to prevent an aortic catastrophe, including aortic rupture or aortic dissection. An aortic rupture is typically a fatal event. An aortic dissection is associated with a high rate of death as well as other serious complications including heart attack, stroke, and paralysis. The risk of these events increases with aortic size.
