Ascending and Aortic Arch Aneurysms

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An ascending aortic aneurysm is a bulge in the portion of the aorta closest to the heart.

The ascending aorta begins at the heart's left ventricle and extends to the aortic arch, or the bend in the aorta. The arch of the aorta gives off branches to the head and arms.

The UPMC Heart and Vascular Institute's Center for Thoracic Aortic Disease treats a full range of disorders and diseases affecting the aorta, such as ascending and aortic arch aneurysms and aortic dissection. Depending on the severity of your condition, our experts may recommend surgical repair or stenting for treatment.

What Are Ascending and Aortic Arch Aneurysms?

Aneurysms (bulging of the aorta) occur because of molecular and connective tissue changes in the wall of the aorta. These changes sometimes cause atherosclerosis and other times cystic medical degeneration (a breakdown of the muscular layer in the aorta), resulting in aneurysms.

Ascending and aortic arch aneurysm risk factors

Ascending aortic aneurysms are the second most common aortic aneurysms, normally found in people in their 60s and 70s. However, many patients who are predisposed to developing aneurysms can have these earlier in their lives.

Risk factors for ascending aortic aneurysms include:

  • Age
  • History of high blood pressure
  • Connective tissue disorders
  • Heart murmurs

The difference between ascending and aortic arch aneurysms

  • An ascending aortic aneurysm is located above the heart and can cause the aortic valve to leak.An ascending aneurysms are the second most common form of aortic aneurism. This condition is commonly diagnosed later in life. This type of aneurysm is located above the heart and can cause the aortic valve to leak.
  • An aortic arch aneurysm is a bulge in the portion of the aorta closest to the heartlocated away from the heart and can involve the blood vessels that supply to your head and neck.

Complications of ascending and aortic arch aneurysms

Aortic aneurysms are dangerous because they may overstretch the aorta, causing it to burst and spill blood outside of the aorta.

Because the aorta is the body’s main supplier of blood, a ruptured aneurysm can cause life-threatening bleeding, which may require immediate surgical attention, such as aortic repair. If the ascending or aortic arch aneurysm has not ruptured, your vascular surgeon may recommend surgery or implanting a stent to help reduce the chance of rupture.

Why choose UPMC for ascending and aortic arch aneurysm care?

The UPMC Center for Thoracic Aortic Disease, a center of excellence at the Heart and Vascular Institute treats a full range of disorders and diseases affecting the aorta, such as aneurysms and aortic dissection.

What Distinguishes Our Center?
  • Our multidisciplinary approach — integrated care designed so you can undergo a comprehensive evaluation at one location, instead of consulting many different specialists to address the various aspects of your disease.
  • Our minimally invasive procedures — such as endovascular thoracic aortic repairs using stent grafts, as well as aortic root reconstructions that preserve the aortic valve.
  • Our surgeons — actively involved in ongoing cardiovascular research to advance patient care and form new strategies to better manage thoracic aortic disease.

To refer a patient, contact the UPMC Center for Thoracic Aortic Disease.

Ascending and Aortic Arch Aneurysm Symptoms and Diagnosis

In most cases, doctors discover ascending and aortic arch aneurysms during exams or tests for other medical problems.

Ascending and aortic arch aneurysm symptoms

Most people with ascending and aortic arch aneurysms do not have any symptoms.

Some may experience:

  • Dull, vague chest pain
  • Shortness of breath
  • Hoarseness
  • Dry cough

Diagnosing ascending and aortic arch aneurysms

If your UPMC heart and vascular doctor suspects an ascending or aortic arch aneurysm during a physical exam, he or she will confirm the diagnosis by:

  • A chest x-ray
  • An echocardiogram

Diagnosing an ascending or aortic arch aneurysm and identifying proper treatment can be dependent on the size of the aneurysm. Additional tests to determine the size and extent of the aneurysm, include:

  • CT scans
  • MRI scans
  • An angiogram

Testing results
Your doctor or nurse will tell you when to expect your test results and will call you when they're available.

To refer a patient, contact the UPMC Center for Thoracic Aortic Disease.

Learn More About Testing for Ascending and Aortic Arch Aneurysms

UPMC Patient Education Materials

Emmi ™ Patient Education Videos

Ascending and Aortic Arch Aneurysm Treatment

Aneurysms in the ascending aorta and aortic arch usually require immediate surgery.

UPMC's Center for Thoracic Aortic Disease offers a full range of state-of-the-art treatment strategies for aortic aneurysms.

Our cardiothoracic surgeons routinely perform:

  • Minimally invasive aortic aneurysm repairs
  • Aortic root reconstructions that preserve the aortic valve
  • Complex valve repair techniques

Treatment strategies for ascending and aortic arch aneurysms

Aortic aneurysm repair

  • Surgery removing the portion of the aorta that contains the aneurysm and replacing it with a mesh graft.
  • Aortic valve may also be affected and need to be reconstructed, replaced, or repaired.

Stenting

  • Inserting a stent-graft — a polyester tube covered by a tubular metal web — through a small incision in the upper thigh into the aorta.
  • X-ray helps guide the stent-graft through the aorta to the aneurysm site.
  • Once in place, blood flows through the stent-graft instead of into the aneurysm, eliminating the chance of rupture.

To refer a patient, contact the UPMC Center for Thoracic Aortic Disease.

Ascending and Aortic Arch Aneurysms Educational Materials

The UPMC Heart and Vascular Institute offers educational information and videos about ascending and aortic arch aneurysms and other heart and vascular diseases and treatments.

Many people find these resources helpful in answering their questions about their condition and preparing them for their procedure or diagnostic test.

The links below will open a new browser window.

UPMC Patient Education Materials

Emmi ™ Patient Education Videos

To refer a patient, contact the UPMC Center for Thoracic Aortic Disease.