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1


Definition of aortic aneurysm


50 % over normal diameter including all 3 layers

2


3 Layers of the vessel?


intima

media

adventitia

3


2 major types of aneurysms


Fusiform- uniform and symetrical involving the entire circumference of the vessel

Sacular- localized outpouching of any portion of the aortic wall

4


Classifications of thoracic aneurysms


ascending aortic aneursym - 60%

aortic arch - 10%

descending - 40 %

thoracoabdomina l- 10 %

5


Thoracoabdominal classifications


I. Proximal descending to proximal abdominal

II. Proximal decending to infrarenal

III. Dista descending with abdominal

IV. Primarily abdominal

CONFUSING A BIT!!!!

 

6


Thoracic aneurysms occur


age 60-70

Males 2-4 times more then females

HTN is present in 60% of cases

up to 13% have multiple aneurysms

7


Thoracic aneurysms most oftern result from


Cystic medial degeneration leading to wall weakening of the aortia

8


Syndroms associated with connective tissue disorders


 Marfans syndrome

Ehlers-Danlos syndrome

9


The vast majority of Descending thoracic aneurysma are associated with


atherosclerosis

10


Most theroies believe it is a breakdown of what causing the weakening of the aortia


elastin and collagen by proteases

11


Aortic disection most often involves the


ascending and thoracic aorta

12


Aoric root dilation is mainly related to what syndrome


Marfans

13

Sinus of valsalva aneurysm can rupture into the R side of the heart causing a continuous ______ and in some cases ___________?


Murmur

Heartfailure

14


Errosion of an aneurysm into the mediastinum can cause what?


hoarseness due to compression of the L recurrent laryangeal nerve

hemidiaphramatic paralysis due to compression of the phrenic nerve

15


What is the perfered procedure to diagnosis of a aortic aneurysm per the ACC/AHA


ECHO (transthoracic perfered)

TEE if the above is incomplete

16


What is the perfered test to detect a thoracic aneurysm


CT and MRI

MRI is prefered for the aortic root

17


CT with contrast is prefered why


best to eval branch vessel pathology