Ascending aortic and aortic arch aneurysms are bulges in the portion of your aorta closest to your heart.
The ascending aorta begins at your heart's left ventricle and extends to your aortic arch, or the bend in your aorta. The arch of your aorta has branches that supply blood to your head and arms. Without close monitoring and treatment, these aneurysms can rupture and cause life-threatening bleeding.
UPMC treats a full range of disorders and diseases affecting the aorta, such as ascending aortic and aortic arch aneurysms and aortic dissection. Depending on the severity of your condition, our experts may recommend surgical repair or stenting for treatment.
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Ascending aortic and aortic arch aneurysms are bulges in the portion of your aorta closest to your heart.
The ascending aorta begins at your heart's left ventricle and extends to your aortic arch, or the bend in your aorta. The arch of your aorta has branches that supply blood to your head and arms.
Ascending aortic aneurysms are the second most common aortic aneurysms, normally found in people in their 60s and 70s. However, if you are predisposed to developing aneurysms, this can happen when you are younger. Aortic arch aneurysms are less common.
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, and at other times, cause a breakdown of the muscular layer in the aorta, resulting in aneurysms.
Risk factors for ascending aortic and aortic arch aneurysms include:
Aortic aneurysms are dangerous because they may overstretch the aorta, causing it to burst or rupture.
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.
You may not be able to control some of your aortic aneurysm risk factors. However, preventing heart disease and chronic conditions can reduce the risk that you will develop an aortic aneurysm. You may be able to reduce your risk of developing aortic aneurysm by:
In most cases, doctors discover ascending aortic and aortic arch aneurysms during exams or tests for other medical problems.
Most people with ascending aortic and aortic arch aneurysms do not have any symptoms. Some may experience:
Aortic aneurysms can cause life-threatening bleeding if they rupture. If you experience symptoms of an aortic rupture, you should dial 911.
Our experts use leading-edge technology and techniques to diagnose and treat ascending aortic and aortic arch aneurysms.
If your UPMC doctor suspects an ascending aortic or aortic arch aneurysm during a physical exam, he or she will confirm the diagnosis by ordering imaging tests.
Your doctor may order several tests to diagnose an ascending aortic or aortic arch aneurysm, including:
Additional tests to determine the size and extent of the aneurysm, include:
Diagnosing an ascending aortic or aortic arch aneurysm and developing appropriate treatment recommendations may depend on the size of your aneurysm. Your care team will follow evidence-based guidelines to determine whether surgery is the best option for you.
Your prognosis with ascending aortic or aortic arch aneurysm depends on the size and extent of your aneurysm. Aortic aneurysm rupture, for example, is a serious, life-threatening condition with a low survival rate. However, if your aneurysm has not ruptured, your doctor may be able to provide surgical treatment that reduces the risk of aortic rupture.
Aneurysms in the ascending aorta and aortic arch usually require immediate surgery. If the aneurysm has not ruptured, your vascular surgeon may recommend surgery or implanting a stent to help reduce the chance of rupture.
UPMC offers a full range of state-of-the-art treatment strategies for aortic aneurysms. Our cardiothoracic surgeons routinely perform:
Treatment strategies for ascending aortic and aortic arch aneurysms include:
Aortic aneurysm repair is a surgical treatment that involves removing the portion of the aorta that contains the aneurysm and replacing it with a mesh graft. During an aortic aneurysm repair, the aortic valve may also be affected and need to be reconstructed, replaced, or repaired.
Stenting includes inserting a stent-graft — a polyester tube covered by a tubular metal web — through a small incision in the upper thigh into the aorta. This is done through an X-ray, which helps guide the stent-graft through the aorta to the aneurysm site.
After the stent is in place, blood flows through the stent-graft instead of into the aneurysm, eliminating the chance of rupture.
This procedure removes the diseased portion of the aorta while preserving the aortic valve. The aortic root is replaced with a graft and the aortic valve is placed within the graft.
This procedure combines replacing the aortic root with a graft and the aortic valve with a mechanical or biological valve.
Surgical treatment for aortic aneurysms can reduce the chances of a life-threatening aortic rupture. However, you may need to take precautions — such as avoiding heavy lifting or strenuous activity — to further reduce your risk.
Your life expectancy depends on whether you receive early, effective treatment, as well as the size and extent of your aneurysm. Your doctor will discuss your life expectancy with you.
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
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