Aortic Arch Aneurysm (Ascending Aorta)

The Aorta

The aorta is the largest blood vessel in the body. It has a cane shape that starts in the heart, briefly curves up towards the head, then curves down through the chest and abdomen. A series of blood vessels attached to the aorta deliver blood to organs and tissues throughout the body. 

Parts of the Aorta 

There are five main parts of the aorta:

• Aortic root: The widest part of the aorta that attaches to the left ventricle of the heart. 
• Aortic valve: Three flaps of tissue, called leaflets, that open and close to allow blood to flow from the heart to the aorta. 
• Ascending aorta: The part of the aorta that curves upward from the heart.
• Aortic arch: The curved part of the aorta that connects the ascending and descending aorta.
• Descending aorta: The part of the aorta that extends down through the chest and abdomen. 

What Is an Aortic Aneurysm?

An aneurysm is a bulge in the aorta. It occurs when the tissues in the aorta become weak. If the bulge gets too big and the aorta bursts, it can cause serious bleeding that can quickly lead to death. 

An aneurysm is classified according to which part of the aorta it affects:

• An abdominal aneurysm is the most common type of aneurysm, in the part of the descending aorta that runs through the abdomen. Abdominal aneurysms account for about 75% of cases. 
• A thoracic aneurysm occurs in the chest. It may affect the ascending aorta, descending aorta and aortic arch.
• A thoracoabdonminal aneurysm occurs where the aorta crosses between the chest and the abdomen. 

Aortic aneurysms typically don’t cause any symptoms. When present, symptoms may include jaw, belly or back pain and shortness of breath. The risk for an aortic aneurysm increases with age. It’s also more common in men and in people with heart disease and a history of smoking. 

How Is It Treated?

Aneurysm treatment depends on the size and location of the bulge. If an aneurysm is small and not causing symptoms, it’s often monitored over time. If an aneurysm becomes large, the weakened part may be replaced with a stent or graft using minimally invasive methods. In some cases, surgery may be required.