Thoracic Aortic Aneurysm（TAA）
A thoracic aortic aneurysm is a weakened area in the major blood vessel that feeds blood to the body (aorta). When the aorta is weak, blood pushing against the vessel wall can cause it to bulge like a balloon (aneurysm).
A thoracic aortic aneurysm is also called a thoracic aneurysm, and aortic dissection can occur because of an aneurysm. A dissection is a tear in the wall of the aorta that can cause life-threatening bleeding or sudden death. Large, fast-growing aneurysms also may rupture, but small and slow-growing aneurysms may never rupture.
Depending on the cause, size and growth rate of thoracic aortic aneurysm, treatment may vary from watchful waiting to emergency surgery. Ideally, surgery can be planned if necessary.
An aortic dissection is a serious condition in which the inner layer of the aorta, the large blood vessel branching off the heart, tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.
Aortic dissection is relatively uncommon. The condition most frequently occurs in men in their 60s and 70s. Symptoms of aortic dissection may mimic those of other diseases, often leading to delays in diagnosis. However, when an aortic dissection is detected early and treated promptly, the chance of survival greatly improves.
Thoracic Aortic Aneurysm
Thoracic aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although some expand over time. How quickly an aortic aneurysm may grow is difficult to predict.
As a thoracic aortic aneurysm grows, some people may notice:
（1）Tenderness or pain in the chest
（5）Shortness of breath
Aortic dissection symptoms may be similar to those of other heart problems, such as a heart attack. Typical signs and symptoms include:
（1）Sudden severe chest or upper back pain, often described as a tearing, ripping or shearing sensation, that radiates to the neck or down the back
（2）Sudden severe abdominal pain
（3）Loss of consciousness
（4）Shortness of breath
（5）Sudden difficulty speaking, loss of vision, weakness or paralysis of one side of your body, similar to those of a stroke
（6）Weak pulse in one arm or thigh compared with the other
Introduction to Surgery
Replace the diseased thoracic aortic segment with vascular graft, the operation method and postoperative curative effect vary with the anatomical part of the thoracic aorta. During the procedure, some technical support may be needed as well, such as cardiopulmonary bypass, deep hypothermia systemic circulation or selective cerebral perfusion. The surgical mortality rate is about 5% to 10%. Surgery complications may include bleeding, severe arrhythmia, insufficient coronary blood supply and complications of central nervous system. 1-year survival rate after surgery is 80% to 90%, and 5-year survival rate is 60% to 80%.
Thoracic Endovascular Aortic Repair(TEVAR)
Introduction to Surgery
Refers to a minimally invasive approach that involves placing a stent-graft in the thoracic or thoracoabdominal aorta for the treatment of a variety of thoracic aortic pathologies. TEVAR was initially used to provide treatment to patients who were not considered to be surgical candidates, and maintained much lower perioperative morbidity and mortality compared with traditional open surgery. With the development of endovascular devices, TEVAR can be also performed for some thoracic aortic pathologies involving branches of aortic arch, including using unibody single-branch endograft.