A “ballooning out” of the main blood vessel that exits your heart to supply blood to the rest of your body (the ‘aorta’), sometimes associated with a common birth abnormality of the heart called Bicuspid Aortic Valve (BAV).
The ‘ballooned out’ aorta is thinner and more fragile than a normal blood vessel, and can be at risk for complete or partial rupture (also called ‘aortic dissection’), and can also cause a leaky heart valve. BAV is strongly associated with aortic valve problems that often require intervention in younger patients.
Mostly, it is a genetic risk that you were born with. Environmental factors such as high blood pressure and smoking may affect the course of the disease.
No, and the natural history is for the aneurysm to continue to grow over time. BAVs can function normally for life, but require close surveillance.
Thoracic aneurysms are often found incidentally by echo (cardiac ultrasound) or chest CT scanning. They occur in predictable locations (especially with BAV), alone or in combination, and the location of the aneurysm(s) has important implications on risk as well as specific management. Aortic valve issues (leaking or blockage) are commonly associated with both BAV and thoracic aneurysm, and can be detected by cardiac ultrasound. BAV-associated aneurysms exhibit more aggressive behavior in general. Most patients will warrant surveillance and counseling alone. Rarely an intervention will be indicated to prevent a complication, ranging from stenting to open heart surgery.
Symptoms - the most important predictor of aortic complications. Fortunately most patients are completely asymptomatic. Chest, back or throat discomfort, especially associated with high blood pressure, may occur. Often, symptoms dictate urgent or even emergent intervention.
Significant personal or family history of connective tissue disorders (Marfan Syndrome), Bicuspid Aortic Valve (BAV), aneurysms and especially aneurysm-related events or premature death of a first degree relative.
Anatomic features: Most doctors pay attention to only one important detail: the maximum diameter of the aneurysm. We use established as well as newly developed sophisticated techniques to better define individual risk. These include comparing aneurysm diameter to overall body dimensions (relative, rather than absolute, aortic size), and we have developed advanced and unique 3-D imaging techniques that may diagnose ‘occult’ BAV, , and detect subtle changes in aneurysm characteristics over time. Certain aneurysms smaller than even 5 cm may require intervention.
We utilize an approach to aneurysm surgery that has been associated with the most advanced ‘brain and heart protection’, and our survival rates for elective aortic surgery are 99% over the last 5 years. We specialize in aortic root surgery and the ‘David’ Procedure (valve-sparing), treating aneurysms in patients who have had previous heart surgery, traditional and hybrid approaches, endovascular stent repair. One other focus of the TABAV is Aortic Valve Repair for both BAV and tri-leaflet aortic valve leaking.
For more information, please call, 201-447-8418 or e-mail us at webinfo@valleyhealth.com