Thoracic aortic aneurysm: unlocking the “silent killer” secrets

Thoracic aortic aneurysm (TAA) is an increasingly recognized condition that is often diagnosed incidentally. This review discusses ten of the most relevant epidemiological and clinical secrets of this disease; (1) the difference in pathogenesis between ascending and descending TAAs. TAAs at these tw...

Full description

Saved in:
Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2019-01, Vol.67 (1), p.1-11
Main Authors: Saeyeldin, Ayman A., Velasquez, Camilo A., Mahmood, Syed Usman B., Brownstein, Adam J., Zafar, Mohammad A., Ziganshin, Bulat A., Elefteriades, John A.
Format: Article
Language:English
Subjects:
Aortic aneurysms
Aortic dissection
Cardiac Surgery
Cardiology
Connective tissue
Coronary vessels
Disease
Females
Genes
Marfan syndrome
Medicine
Medicine & Public Health
Mortality
Mutation
Smooth muscle
Special Edition
Surgery
Surgical Oncology
Thoracic Surgery
Womens health
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Thoracic aortic aneurysm (TAA) is an increasingly recognized condition that is often diagnosed incidentally. This review discusses ten of the most relevant epidemiological and clinical secrets of this disease; (1) the difference in pathogenesis between ascending and descending TAAs. TAAs at these two sites act as different diseases, which is related to the different embryologic origins of the ascending and descending aorta. (2) The familial pattern and genetics of thoracic aneurysms. Syndromic TAAs only explain 5% of the pattern of inheritance. (3) The effect of female sex on TAA growth and outcome. Females have been found to have worse outcomes compared to males. (4) Guilt by Association. TAAs are associated with abdominal aortic aneurysms, intracranial aneurysms, bicuspid aortic valve, and inflammatory disorders. (5) Natural history of TAAs. Important findings have been made regarding the expansion rate (in relation to familial pattern, location and size), and also regarding the risk of rupture or dissection. (6) The aortic size paradox. Size only is not a sufficient predictor of risk of dissection. (7) Biomarker void. Although many serum biomarkers have been studied, imaging remains the only reliable method for diagnosis and follow-up. (8) Indications for repair. Decisions are made depending on symptoms, location, size, and familial patterns. (9) Types of repair. Both open and endovascular repair options are available for certain TAAs. (10) Medical treatment. The efficacy of prescribing beta blockers, angiotensin converting enzyme inhibitors or angiotensin receptor blockers remains dubious.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-017-0874-x