Aortic Diseases + Aneurysms

Your aorta is the largest artery in your body, acting like a highway that carries blood from your heart to the rest of your body. Aortic diseases happen when there’s a problem with this important artery. One common issue is an aortic aneurysm, where part of the aorta weakens and bulges.

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Aortic diseases + aneurysms: Personalized care for a healthy heart

Each year, we treat thousands of people living with aortic diseases and aneurysms. From your first diagnosis to preventive care visits, our expert team is here with you every step of the way.

Aortic diseases and aneurysms can disrupt the flow of oxygen-rich blood, nutrients and hormones to your organs. When the aorta is affected, it can lead to serious complications like internal bleeding, aneurysms or restricted blood flow to vital organs.

By bringing together experts from vascular surgery, interventional radiology, interventional cardiology and infectious disease, we’ll create the best treatment plan for you, ensuring your heart and aorta stay healthy and strong.

Amanda Vest, MD, Director of the Advanced Heart Failure Program at Tufts Medical Center, is checking patient with a stethoscope during appointment.

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Conditions

Aortic disease is one of the most common types of cardiovascular (heart) disease. The aorta is the largest artery in your body, making it vulnerable to conditions like aortic aneurysms, which can change the size, shape and function of the aorta.

An aortic aneurysm occurs when a weak spot forms on the aorta, causing it to bulge. The aorta is flexible and adjusts to blood flow, but conditions like high cholesterol, high blood pressure and plaque build-up can weaken the walls of the aorta over time. As the walls weaken, the risk of aortic aneurysms forming or rupturing increases. The 2 most common types of aortic aneurysms are:

Abdominal aortic aneurysm

An abdominal aortic aneurysm or AAA is when part of the aorta in your abdomen or belly bulges or gets larger than normal. The aorta is the big blood vessel that carries blood from your heart to the rest of your body. If an aneurysm in this area grows too large or bursts, it can be very dangerous.

Talk to your primary care doctor or cardiologist about getting screened if you:

Are a man or assigned male at birth (AMAB) between 65-75 years old
Have ever smoked
Feel sudden or severe pain in your back or abdomen
Have a family history of AAA

Thoracic aortic aneurysm

These occur in the chest and usually develop slowly and may not cause symptoms at first. But if they grow large enough, they can press on nearby structures in your chest (causing hoarseness or difficulty swallowing) and even rupture or tear (causing sharp, searing pain between your shoulder blades). Talk to your primary care doctor or cardiologist about getting screened if you:

Have a family history of aortic aneurysms
Are at high risk due to other health conditions (such as high blood pressure or connective tissue disorders)
Experience symptoms like hoarseness, difficulty swallowing or sharp pain between your shoulder blades

Testing

An aortic aneurysm is a common condition that affects the aorta. Most of the time, it doesn’t cause any symptoms and may only be found during tests for other health problems. To understand your heart better, doctors use several imaging tests, including:

Cardiac MRI
CT scan (with or without dye injection)
Echocardiogram
MRI
Magnetic resonance angiography (MRA)
Right heart catheterization
Ultrasound

Treatments

An aneurysm can stay the same size for years or grow quickly. If the bulge stays small, doctors may recommend regular monitoring with ultrasounds, CT scans or MRIs. However, if an aneurysm grows or causes problems, surgery may be necessary, especially if:

The aneurysm is larger than 5cm (about the size of a lime)
The aneurysm grows more than 0.5cm in one year (about half the size of a blueberry)
You have serious, life-threatening bleeding
Your aneurysm may rupture

If surgery is needed, your doctor can repair or replace the diseased artery using advanced equipment. There are 2 main approaches for aneurysms:

Endovascular repair: This is a minimally invasive surgery. A small incision (usually in the groin) is made, and a catheter is used to guide a stent or graft to the aneurysm. This approach usually results in less pain and a faster recovery.
Open surgery: This surgery involves a larger incision in the abdomen or chest to access the aorta and repair the aneurysm. It’s typically used when other methods aren’t possible or in emergencies.

Our skilled cardiac surgeons and interventional radiologists work together to treat complex aneurysms. Using detailed 3D images, we can place custom endovascular stent grafts. They also work with interventional cardiologists, who use tiny catheters and small incisions to treat diseased parts of the heart.

FAQs

What support will I receive during my wellness journey?

Throughout your wellness journey, you’ll have a team of experts dedicated to treating aortic disease and aneurysms. Your doctor will guide you through heart-healthy lifestyle changes and may recommend regular check-ups, medications, or surgery to manage your condition.

How can I prevent aortic disease and aneurysms?

Heart disease can often develop without showing symptoms until it’s more serious. To reduce your risk, it’s important to make heart-healthy choices. These may include:

Exercising regularly
Maintaining a healthy diet with reduced salt
Managing hypertension
Quitting smoking
Reducing alcohol use
Reducing cholesterol levels

Your care team is always here to help and offer support.

Why are regular check-ups and medications important for aortic disease?

Most heart disease can be prevented by maintaining healthy blood pressure and cholesterol. Many people don’t realize they have high blood pressure or cholesterol until problems arise, so routine check-ups and tests are important to catch these issues early.

In addition to monitoring, your doctor may recommend medications to control blood pressure and cholesterol. This can help slow the growth of an aneurysm and reduce the risk of it rupturing.