The obvious benefit of surgery for thoracic aortic aneurysm is treatment of the aneurysm, and prevention of a possible rupture. The drawback is the danger associated with surgery and the risk of death in the operating room. The pros and cons of surgery for thoracic aortic aneurysm have to be weighed on an individual basis. Patients considering surgical treatment of this vascular condition should meet with a cardiothoracic surgeon to learn more about their specific situations and to get advice on medical treatment and available options.
A thoracic aortic aneurysm is a swelling of the aorta, the largest artery in the body, as it passes through the thoracic cavity. As the artery swells, the walls weaken, putting it at risk of rupture. If it ruptures, the patient can bleed out and die in a matter of minutes. Signs of rupture are indicators for immediate emergency surgery to repair the aorta, and in a surgical emergency, patients are advised to consent to surgery, rather than weighing the pros and cons, as they will die without treatment.
In non-emergency situations where patients are diagnosed with this condition as a result of a medical imaging study, there are three options for management. One is a wait and see approach, where the size and growth of the aneurysm is monitored with regular follow-up appointments. Another is endovascular surgery, a less invasive form of surgery. Finally, open surgery can be performed to repair the aneurysm.
Surgery for thoracic aortic aneurysm is usually not recommended if the aneurysm is less than two inches (five centimeters), because at this point, the risks of surgery are greater than the risks of dying from the aneurysm. However, there may be special cases where patients are advised to get surgery on a relatively small aneurysm, such as in the case of patients with genetic conditions predisposing them to rupture, or in patients with rapidly growing aneurysms, where waiting may not be advised because rupture could be a bigger risk.
When considering surgery for thoracic aortic aneurysm, the patient's general health must also be considered. Some patients are poor candidates for surgery as a result of age, kidney disease, lung problems, and other medical issues. For these patients, the risks of surgery may be greater than leaving the aneurysm untreated, and it may be better to wait and monitor the aneurysm, taking action if it grows larger.
Patients can discuss with a surgeon whether they are good candidates for surgery for thoracic aortic aneurysm on the basis of their cases and their medical histories. While surgeons are in their line of work because they love surgery, they will not recommend a repair procedure if it is not necessary or the risks for the patient are too great.