An aortic root aneurysm is a bulge or weakened area that occurs at the beginning, or root, of your aorta — your body's largest blood vessel. Aortic root aneurysms often have no symptoms. Doctors find them during x-rays or CT scans to diagnose other conditions.
At UPMC, we offer complete cardiovascular care. We use a team approach to tailor treatment plans for complex conditions, including aortic root aneurysms.
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The aorta is the body's largest blood vessel. It transports blood to the body from the heart.
An aneurysm occurs when a blood vessel stretches or bulges in one place. An aortic root aneurysm occurs in the beginning, or root, of your aorta.
Doctors also call an aortic root aneurysm a dilated aortic root.
Aortic root aneurysm affects between 5-10 people out of 100,000 in the U.S.
Aortic aneurysms occur because of molecular and connective tissue changes in the wall of the aorta. These changes sometimes cause the aorta to narrow or become blocked due to conditions like atherosclerosis, which causes plaque to build up inside the arteries. This can cause a breakdown of the muscular layer in the aorta, resulting in aneurysms.
Certain health problems increase the risk for aortic root aneurysms, including genetic or connective tissue disorders such as:
Autoimmune or inflammatory diseases that affect the arteries also raise your risk. These include:
Other health and lifestyle factors that increase aortic root aneurysm risk are:
Aortic root aneurysms can also result from birth defects of the heart or blunt trauma (an extreme blow) to the chest.
The aortic root has a valve that allows blood to pass from the heart to the aorta.
When the heart pumps blood out, the valve opens. The valve then closes to prevent blood from flowing back in from the aorta.
When an aneurysm stretches the aorta, the valve can't fully close. Because the valve stays open, the blood pumped into the aorta can flow back into the heart.
This causes problems such as:
Though some people are at higher risk for this disease, it doesn't mean they'll form an aortic root aneurysm. If you're at higher risk for an aortic root aneurysm, ways to help prevent it include:
If you received an aortic root aneurysm diagnosis, you should:
Aortic root aneurysms often have no symptoms. Some possible aneurysm symptoms are:
If the aneurysm dissects or ruptures, symptoms include:
If you have symptoms of an aortic root aneurysm, schedule an appointment with your doctor right away. Early diagnosis and treatment can reduce your risk of a life-threatening aortic rupture.
An aortic dissection or rupture is a medical emergency. If you experience symptoms or aortic dissection or rupture, dial 911.
Your doctor will recommend a treatment plan based on the size of your aneurysm and any other health issues you may have.
The aortic root dilation, or bulge, may grow larger. It will not shrink on its own. Treatment recommendations may include:
If the aneurysm is small and not causing any problems, your doctor may suggest waiting to see if the aneurysm is growing.
If your aneurysm is 50 percent larger than the rest of the artery, you may need surgery. Doctors mainly suggest surgery when an aortic root dilation reaches five centimeters.
Doctors can provide surgical treatment for aortic root aneurysm by:
An aortic root replacement procedure replaces a section of the aorta with an artificial tube, or graft. The aortic valve is also removed and replaced with a mechanical or biological valve.
During open aortic root aneurysm repair, your surgeon will:
After surgery, you will stay in the hospital for 5-7 days. Most patients make a complete recovery in 2-3 months, depending on the complexity of your surgery, your overall health, and whether you have other conditions such as heart, lung, or kidney disease.
Your surgeon may recommend repairing your aortic root aneurysm with a minimally invasive EVAR procedure. Whether or not you can have an EVAR procedure depends on the shape, location, and extent of the aneurysm.
In contrast to a traditional “open" surgery, no big incisions are made in the chest. Instead, the arteries in the groin are accessed either by a needle puncture or a small incision.
During EVAR, your doctor will:
After an EVAR, most people recover quickly and can often go home the next day. However, yearly follow-ups with your surgeon are required because the stent can shift over time.
EVAR reduces your hospital stay by 2-3 days and requires less recovery time when compared to traditional open thoracic aortic aneurysm repair.
If EVAR is not an option for you, you may have access to other minimally invasive treatment options. UPMC routinely participates in clinical trials of leading-edge devices to treat complex aortic aneurysms.
Many open aneurysm repairs are successful in the long term with few complications. Follow-up after open aneurysm repair is less frequent than that for EVAR, with most patients coming back every 2-3 years for a checkup.
However, EVAR requires more frequent follow-up visits and imaging studies to ensure that the graft continues to function properly. You also may require periodic maintenance procedures.
Your life expectancy depends on whether you receive early, effective treatment, the size and extent of your aneurysm, and whether your aneurysm has ruptured. Your doctor will discuss your life expectancy with you.
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
