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Thoracic aortic aneurysms are found within the chest; these are further classified as ascending, aortic arch, or descending aneurysms. Abdominal aortic aneurysms, "AAA" or "Triple A", the most common form of aortic aneurysm, involve that segment of the aorta within the abdominal cavity. Thoracoabdominal aortic aneurysms involve both the ...
The aortic wall dilatation at the commissural level causes the cusps to effectively shorten and prevent them from converging during systole, which results in aortic valve incompetence. The arch is typically spared from the aneurysmal process, though it may involve the entire ascending aorta. The ectatic aorta may experience dissections.
The aorta normally has three small pouches that sit directly above the aortic valve (the sinuses of Valsalva), and an aneurysm of one of these sinuses is a thin-walled swelling. Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [1]
A thoracic aortic aneurysm is an aortic aneurysm that presents primarily in the thorax. A thoracic aortic aneurysm is the "ballooning" of the upper aspect of the aorta, above the diaphragm. Untreated or unrecognized they can be fatal due to dissection or "popping" of the aneurysm leading to nearly instant death.
A true aneurysm is one that involves all three layers of the wall of an artery (intima, media and adventitia).True aneurysms include atherosclerotic, syphilitic, and congenital aneurysms, as well as ventricular aneurysms that follow transmural myocardial infarctions (aneurysms that involve all layers of the attenuated wall of the heart are also considered true aneurysms).
Of these cases around 28% are confined to the thoracic portion of the aorta including the ascending aorta, aorta arch, and the descending aorta. [10] Of the thoracic aortic injuries the ligament arteriosum is the most common location followed by the portion of the aorta after the origin of the left subclavian artery. [10]
Aortic unfolding is an abnormality visible on a chest X-ray, that shows widening of the mediastinum which may mimic the appearance of a thoracic aortic aneurysm. [1]With aging, the ascending portion of the thoracic aorta increases in length by approximately 12% per decade, whereas the diameter increases by just 3% per decade.
A thoracic aorta diameter greater than 3.5 cm is generally considered dilated, whereas a diameter greater than 4.5 cm is generally considered to be a thoracic aortic aneurysm. [4] Still, the average diameter in the population varies by for example age and sex.
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