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Aortic valve disease aortic insufficiency aortic aneurysm causes of aortic aneurysm symptoms of aortic aneurysm complications of aortic aneurysm diagnosis of aortic aneurysm treatment for aortic aneurysms abdominal aortic aneurysm (AAA) symptoms of abdominal aortic aneurysm diagnosis of abdominal aortic aneurysm treatment for abdominal aortic aneurysm aortic valve regurgitation causes of aortic valve regurgitation symptoms of aortic regurgitation diagnosis of aortic valve regurgitation treatment for aortic regurgitation aortic valve stenosis causes of aortic stenosis symptoms of aortic stenosis diagnosis of aortic stenosis treatment for aortic stenosis aortic valve replacement surgery other heart valve disorders {mitral valve disease mitral valve prolapse mitral valve regurgitation mitral stenosis mitral valve repair and replacement pulmonic valve stenosis tricuspid regurgitation tricuspid stenosis heart valve replacement and repair}

What's the treatment for aortic aneurysms?

Medical therapy of aortic aneurysms involves strict blood pressure control. This does not treat the aortic aneurysm per se, but tight blood pressure control with prevention of hypertension may decrease the rate of expansion of the aneurysm. The definitive treatment for an aortic aneurysm is surgical repair of the aorta. This typically involves opening up of the dilated

portion of the aorta and insertion of a dacron patch tube. Once the tube is sewn into the proximal and distal portions of the aorta, the aneurysmal sac is closed around the artificial tube.

A recent treatment option is the placement of a stent via a percutaneous technique into the diseased portion of the aorta. Percutaneous stenting of aortic aneurysms has a lower mortality rate than an open surgical approach, and has been used in individuals with co-morbid conditions that make them a high risk for surgery.

The determination of when surgery should be performed is usually based on the diameter of the aneurysm. A rapidly expanding aneurysm should be operated on as soon as feasible, since it has a greater chance of rupture. Slowly expanding aortic aneurysms may be followed by routine diagnostic testing (ie: CT scan or ultrasound imaging). If the aortic aneurysm grows at a rate of more than 1 cm/year, surgical treatment should be electively performed.

The current treatment guidelines suggest elective surgical repair of an abdominal aortic aneurysm when the diameter of the aneurysm is greater than 5cm. However, recent data suggests medical management for abdominal aneurysms with a diameter of less than 5.5 cm.

In the case of thoracic aortic aneurysms, the current recommendation for treatment of an ascending aortic aneurysm is elective repair when the diameter is greater than 5.5 cm if the individual does not suffer from Marfan's syndrome. If the aneurysm is below the arch of the aorta, the treatment of a descending thoracic aortic aneurysm is elective repair when the diameter is greater than 6.5 cm. In individuals with Marfan's syndrome, surgical treatment of an ascending aneurysm should be performed when the diameter of the aorta reaches 5cm, while treatment of a descending thoracic aneurysm should be performed when the diameter of the aorta reaches 6 cm.

If the aneurysm is small and there are no symptoms (for example, if the aneurysm is found during a routine physical examination), your health care provider may recommend periodic evaluation, usually with annual ultrasound examination, to watch for changes.

Symptomatic aneurysms usually require surgical treatment to prevent complications. Antihypertensive medications may be prescribed before surgery to reduce blood pressure. Other medications may include analgesics to relieve pain.

Surgical repair or replacement of the section of aorta is recommended for patients with symptoms, as they are at high risk of fatal rupture. Repair is also recommended for patients with aneurysms greater than 5 cm in diameter. Stenting is also a treatment option. The goal of treatment is to perform surgery before complications develop.

Stenting involves the use of a tube placed inside the vessel and can be performed without an abdominal incision, with specialized catheters that are introduced through arteries at the groin. Not all patients with abdominal aortic aneurysms are candidates for stenting, however.

The risk of complications increases as the size of the aneurysm increases. Because surgery for abdominal aortic aneurysm is risky, the surgeon may wait for the aneurysm to expand to a certain size before operating (that is, when the risk of complications exceeds the risk of surgery).

More information on aortic aneurysm and other aortic valve diseases

What is an aortic aneurysm? - An aortic aneurysm is a localized dilatation or aneurysm of the aorta, usually representing an underlying weakness in the wall of the aorta at that location.
What causes an aortic aneurysm? - Most aortic aneurysms occur in the abdominal aorta, the main cause being arteriosclerosis. There is a familial tendency to aortic aneurysms.
What're the symptoms of aortic aneurysm? - Most intact aortic aneurysms do not produce any symptoms. The ballooning of the aneurysm does not cause any symptoms unless it becomes large enough.
What're the complications of aortic aneurysm? - Half of all persons with untreated abdominal aortic aneurysms die of rupture within 5 years. Spontaneous blockage of the aorta can also occur.
How is aortic aneurysm diagnosed? - Aortic aneurysms can be diagnosed from their symptoms. An ultrasound scan is the easiest way to detect an aortic aneurysm.
What's the treatment for aortic aneurysms? - Medical therapy of aortic aneurysms involves strict blood pressure control. Symptomatic aneurysms require surgical treatment to prevent complications.
What's an abdominal aortic aneurysm (AAA)? - An abdominal aortic aneurysm (AAA) is a bulge in the aorta in abdomen. Most AAAs occur in association with advanced atherosclerosis.
What're the symptoms of abdominal aortic aneurysm? - Symptoms of abdominal aortic aneurysm include a pulsing sensation in the abdomen, and pain ranging from mild to severe.
How is abdominal aortic aneurysm diagnosed? - Because abdominal aortic aneurysms may not cause any symptoms at the beginning, they are diagnosed by chance during a physical examination.
What's the treatment for abdominal aortic aneurysm? - Treatment of abdominal aortic aneurysm depends upon the size of the aneurysm. Surgical treatment of abdominal aortic aneurysm is often preformed.
What is aortic valve disease? - An aortic valve disorder usually does not cause any symptoms in its early stages. Infection on an abnormal aortic valve leads to a disease called infective endocarditis.
What is aortic insufficiency? - Aortic insufficiency is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole.
What's aortic valve regurgitation? - Aortic valve regurgitation develops hen the valve leaflets fail to close properly during the heart's relaxation phase.
What causes aortic valve regurgitation? - Causes of aortic valve regurgitation include being born with a defective aortic valve, wear and tear from aging, infection of the lining of the heart.
What're the symptoms of aortic regurgitation? - Symptoms of aortic regurgitation include chest pain, excessive sweating, palpitations, shortness of breath that worsens with exertion or lying down.
How is aortic valve regurgitation diagnosed? - A doctor diagnoses aortic valve regurgitation by hearing a heart murmur or other abnormal noises when listening with a stethoscope.
What're the treatments for aortic regurgitation? - Medicines to improve the pumping action of the heart may be given to reduce the severity of the regurgitation. Valve replacement surgery is usually recommended.
What is aortic stenosis? - Aortic valve stenosis is a heart condition caused by narrowing of the aortic valve. Aortic stenosis is the inability of the aortic valve to open completely.
What causes aortic stenosis? - Congenital aortic stenosis is caused by improper development of the aortic valve in the first 8 weeks of fetal growth. Age related calcification of the valve is the most common cause.
What're the symptoms of aortic stenosis? - Symptoms of aortic stenosis include shortness of breath (dyspnea), passing out (syncope), and chest pain (angina pectoris).
How is aortic stenosis diagnosed? - Aortic stenosis is often diagnosed due to the presence of a heart murmur. The gold standard for diagnosis is an echocardiogram.
What's the treatment for aortic stenosis? - Patients with mild aortic stenosis do not require treatment. Valve replacement surgery is indicated for patients with severe aortic stenosis.
Aortic valve replacement surgery - Aortic valve replacement surgery is an open heart procedure for treatment of narrowing (stenosis) or leakage (regurgitation) of the aortic valve.
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