Indications

The decision to replace the thoracoabdominal aorta is based on a number of criteria, namely symptoms, size, growth rate, and family history.

Symptoms
In the setting of a thoracoabdominal aortic aneurysm, chest pain or back or abdominal pain is a concerning symptom and may prompt definitive repair urgently. If you have an aneurysm and are experiencing chest pain, you should contact your physician or the nearest emergency room immediately.

Size
While there is no absolute size cutoff, most surgeons will begin to recommend repair of thoracoabdominal aortic aneurysms when they reach approximately 5 cm in size. Even patients with smaller aneurysms should be followed with CT scans at regular intervals to evaluate growth of the aneurysm, as directed by their physician. For patients with Marfan's Disease, surgery may be recommended for smaller sizes.

Growth Rate
The rate of change in size of a thoracoabdominal aortic aneurysm may also influence the timing of surgery. Generally, the faster the aneurysm grows, the sooner it should be repaired. Repair would be recommended if there is documented expansion greater than 1cm in a year.

Family History
Operation may be recommended sooner based on a patient's individual family history. Those with history of genetic diseases, such as Marfan's, Ehler's-Danlos or other family history of aortic diseases may be candidates for surgical treatment earlier in their course