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Ascending Aortic Aneurysm Treatment

Ascending Aortic Aneurysm Treatment: What You Need to Know

A bulging in the upper section of the aorta, the body’s main artery, is medically known as an ascending aortic aneurysm. The aorta is a significant blood artery responsible for moving oxygenated blood from the heart to the rest of the body. Ascending aortic aneurysms are extremely dangerous because they can cause life-threatening internal bleeding if they burst or tear.

A doctor can treat ascending aortic aneurysms in many differnt ways, depending on the severity of the condition, the patient’s age, and the rate at which the aneurysm is expanding–aortic root replacement, aortic valve-sparing procedures, and endovascular stent grafts. 

Improving outcomes and lowering the risk of life-threatening complications from ascending aortic aneurysms requires early detection and appropriate care.

Understanding The Cardiovascular System

The cardiovascular system, also called the circulatory system, consists of the heart and a network of blood vessels carrying blood, oxygen, and nutrition to all body parts. The aorta is the heart’s main artery and a vital part of the circulatory system. It is the primary artery where the heart’s left ventricle pumps oxygenated blood to the rest of the body.

The heart’s left ventricle originates from the aorta, which begins with the ascending aorta and climbs vertically. The aorta delivers oxygenated blood to the rest of the circulatory system, including the coronary arteries that feed the heart muscle.

The aortic arch forms when the curved ascending aorta reaches the top of the heart. Several main arteries nourishing the brain, neck, and upper limbs branch off the aortic arch. The left common carotid artery, left subclavian artery, and brachiocephalic trunk all belong to this group.

The aorta continues below the aortic arch as the descending aorta passes through the back of the chest and abdomen. The descending aorta carries oxygenated blood to the heart, brain, kidneys, liver, and other vital organs in the chest, belly, and legs.

Ascending Aortic Aneurysm: An In-Depth Look

Most of the time, there are no signs in the early stages of an ascending aortic aneurysm, which makes them very dangerous. Some people may feel pain or discomfort in their chest, which can feel like a dull ache or pressure that spreads to their back, neck, or shoulders.

Breathing problems may occur as the aneurysm grows and presses on the lung tissue or the area around the air passages. Hoarseness of voice or prolonged coughing may be signs of an aneurysm pressing on nearby nerves and structures.

Some people have trouble swallowing because of the pressure developing ascending aortic aneurysms on the esophagus. In addition to being visible or palpable, a big aneurysm near the chest wall may cause a pulsating mass.

An ascending aortic aneurysm risk increases with a family history of aortic or connective tissue disorders. Aortic aneurysms are more common in people with certain genetic diseases such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome. The likelihood of having an aortic aneurysm also increases with age. Those above the age of 60 have a higher incidence of them.

Diagnostic Methods for Ascending Aortic Aneurysm

The results of diagnostic tests are essential in developing therapeutic strategies and evaluating treatment outcomes. After a physical examination and blood test, a physician may request imaging tests like Computed Tomography (CT) Scan or Magnetic Resonance Imaging (MRI). 

The physician may also use Echocardiogram to create detailed images of the heart and aorta. It can detect the presence of an ascending aortic aneurysm, assess its size and location, and evaluate the heart’s function.

Early detection allows healthcare providers to closely monitor the aneurysm’s size and growth rate, enabling timely intervention before it reaches a dangerous size. Once the physician suspects it, regular monitoring identifies signs of aortic wall degeneration or structural changes, which could increase the dissection risk, and take appropriate action to prevent it.

When an ascending aortic aneurysm is large or growing rapidly, repair or reinforcement of the weakening aortic wall may be essential through surgical or endovascular intervention. A better prognosis can be expected from elective, preplanned surgeries than emergency interventions following a rupture or dissection.

Treatment Options for Ascending Aortic Aneurysm

Medications address related risk factors and conditions that may contribute to the progression or complications of the aneurysm. Though beta-blockers, antihypertensive medications, statins, and antiplatelet agents may not directly treat ascending aortic aneurysms, it is part of a comprehensive plan with regular monitoring and lifestyle modification.

When an aneurysm has developed, surgery is the best way to treat it. Surgeons operate on the aortic arch located in the chest. These operations reduce the danger of aortic rupture or dissection and restore normal blood flow by repairing or replacing the damaged part of the aorta. 

A vascular surgeon may do an endovascular system repair using a stent graft for people who don’t want surgery but want to treat their aneurysm. The main job of a stent graft is to strengthen the part of the artery that has been weakened and dilated by the aneurysm. The stent graft is a fabric-covered metal mesh tube that supports the aortic wall, keeping the aneurysm from getting bigger and lowering the chance of rupturing.

Navigating The Treatment Pathway: Role of Medical Professionals

Different medical professionals can help in diagnosing and managing ascending aortic aneurysms. Primary care physicians usually do the initial assessment and diagnosis and refer the patient to specialists for further treatment. 

Cardiologists are crucial in evaluating and managing heart-related issues associated with ascending aortic aneurysms. Cardiothoracic and vascular surgeons are experts in surgical procedures that may treat this type of aneurysm.

Medical professionals not only play a role in diagnosing and treating ascending aortic aneurysms. Nutritionists or dietitians can also offer guidance on proper nutrition and dietary modifications to support the patient’s overall health and recovery.

The Patient Journey: Recovery and Rehabilitation

Depending on the type of treatment for an ascending aortic aneurysm, the healing process and what to expect can be different. The length of the hospital stay can vary, generally between a few days and a week. It depends on how complicated the procedure is and how healthy the patient is in general.

Recovery from treatment for an aortic aneurysm is a slow process. Physical therapy or occupational therapy may be suggested to help the patient heal and regain strength and mobility, especially after an open surgical repair.

Physical therapy is about getting your strength, movement, and flexibility back. It helps people with surgery or arterial repair get their bodies working again. Occupational therapy helps people regain the skills they need to do daily tasks. It focuses on making people more independent and improving their quality of life while they are getting better.

Prognosis and Quality of Life Post Treatment

Anxiety and fear about aneurysm rupture alleviate after a successful surgery. A patient’s physical health, pre-existing symptoms (if any), and confidence in their heart’s health may all improve due to treatment.

Additionally, reduced risk of complications can lead to greater overall well-being and confidence in resuming daily activities. Patients may feel more empowered to engage in physical and social activities without the constant fear of health-related emergencies.

Lifestyle modifications and prevention measures are paramount for patients post-treatment for ascending aortic aneurysms. A heart-healthy diet, managed blood pressure, and regular exercise can all contribute to long-term cardiovascular health, preventing complications and improving the overall quality of life.

Regular check-ups and follow-up appointments with healthcare providers are also crucial for monitoring the patient’s condition and ensuring that a patient follows preventive measures effectively.

Recent Advances in Ascending Aortic Aneurysm Treatment

There are emerging clinical studies on several new or developing treatments for ascending aortic aneurysms. Gene therapy is a way to treat or avoid diseases by changing genes or adding new genes. Regarding aortic aneurysms, experts are looking into ways to use gene therapy to strengthen the aortic wall and stop it from getting bigger.

Tissue engineering and regenerative medicine are also in the process of clinical studies. The study aims to use biological materials, cells, and scaffolds to make new tissues or fix broken ones in these treatments. Researchers are investigating whether tissue-engineered grafts could replace the weaker part of the aorta to lower the risk of long-term problems.

Patient Stories and Experiences

Christopher Webbley, a 51-year-old man from the UK, was fit and active despite being overweight. He had to go to the hospital because of chest pain, not knowing that he had a nearly 6mm thoracic aneurysm and would need immediate surgery. Aside from the thoracic surgery, he also had a full breastbone surgery because of the location of the aneurysm.

Although he suffered a stroke after the surgery, it became successful, and he does well today. The post-surgery care, modified lifestyle, and diet also helped his recovery.

Another patient who suffered from ascending aortic aneurysm was an athlete. John Tegan does strength training and regular cardio despite his age. At 60, his doctor informed him that there was something wrong. Though the aneurysm was not an immediate threat, its risk of rupture was high. He had a minimally-invasive surgery and regular care until he was ready for rehab.

Frequently Asked Questions About Ascending Aortic Aneurysm Treatment

Can ascending aortic aneurysms be treated with medications?

Most of the time, health professionals do not prescribe medications directly to treat ascending aortic aneurysms. They provide prescriptions to control blood pressure, slow the heart rate, or deal with other heart disease risk factors to stop the aneurysm from getting bigger.

How long is the recovery period after surgery for an ascending aortic aneurysm?

The time it takes to get better after open surgery for an ascending aortic aneurysm depends on the person and how complicated the operation is. Full recovery could take anywhere from a few weeks to a few months. During this time, patients should avoid strenuous activities and follow guidelines for care after surgery.

Can an ascending aortic aneurysm return after treatment?

If the repair works, a repaired ascending aortic aneurysm is not likely to come back. But it’s important to keep attending follow-up appointments and changing your life to avoid getting new aneurysms or problems.

Patient Support and Resources

The American Heart Association provides information on aortic aneurysms, preventive measures, treatment options, and steps to reduce the risk of complications. The website also offers a search tool to find local AHA-approved healthcare providers.

MedlinePlus, a US National Library of Medicine service, provides patient-friendly information on aortic aneurysms. It includes an overview, statistics, videos, and links to reputable sources for additional information.

Mended Hearts is a national nonprofit organization supporting heart patients and their families. They offer local chapters and online support groups for individuals with heart conditions, including aortic aneurysms.

There are also Facebook groups like Ascending Aortic Aneurysm Support Group, where patients of any aneurysm can share their struggles to support each other. It provides a sense of community and provides comfort not only for patients but for their families as well.

Conclusion

Ascending aortic aneurysms need to get treated in a way that involves a team of skilled medical professionals and the patient’s active involvement. People with ascending aortic aneurysms can improve their long-term outcomes, quality of life, and general heart health with early diagnosis, proper treatment, and a commitment to changing their lifestyle. 

Patients and their families need information, help, and resources from reputable organizations to make good choices and feel confident as they go through this medical journey.

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About the Author

Rich Devman

Rich Devman

In the year 2020, I encountered one of the most significant challenges of my life when I was diagnosed with an ascending aortic aneurysm. This condition, considered one of the most severe and dangerous forms of cardiovascular disease, required immediate surgical intervention. The ascending aorta, which is the segment of the aorta that rises from the heart and delivers oxygen-rich blood to the body, had developed an abnormal bulge in its wall, known as an aneurysm. Left untreated, such an aneurysm could lead to life-threatening conditions such as aortic dissection or even aortic rupture. In response to this urgent health crisis, I underwent emergency surgery, a procedure aimed to repair the dilated section of my aorta, thereby preventing a potential disaster. This type of surgery often involves a procedure known as an open chest aneurysm repair, where the weakened part of the aorta is replaced with a synthetic tube, a demanding operation that calls for extensive expertise and precision from the surgical team. Surviving such a major health scare deeply impacted my life, leading me to channel my experience into something constructive and helpful for others going through the same situation. As a result, I took it upon myself to establish this website and a corresponding Facebook group. These platforms are designed to provide support, encouragement, and a sense of community for those grappling with the reality of an ascending aortic aneurysm. I often refer to those of us who have had our aneurysms discovered and treated before a catastrophic event as "the lucky ones." The unfortunate reality is that aortic aneurysms are often termed "silent killers" due to their propensity to remain asymptomatic until they rupture or dissect, at which point it's often too late for intervention. Thus, we, who were diagnosed and treated timely, represent the fortunate minority, having had our aneurysms detected before the worst could happen. Through this website and our Facebook group, I aim to raise awareness, provide critical information about the condition, share personal experiences, and, above all, offer a comforting hand to those who are facing this daunting journey. Together, we can turn our brushes with mortality into a beacon of hope for others. Also, I make websites look pretty and rank them on search engines, raise a super amazing kid, and I have a beautiful wife.