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(Circulation. 2005;111:816-828.)
© 2005 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Thoracic and Abdominal Aortic Aneurysms

Eric M. Isselbacher, MD

From the Thoracic Aortic Center and Cardiology Division, Massachusetts General Hospital, Boston, Mass.

Correspondence to Eric M. Isselbacher, MD, Thoracic Aortic Center and Cardiology Division, Massachusetts General Hospital, 55 Fruit St, YAW-5A-5800, Boston, MA 02114. E-mail eisselbacher@partners.org

Key Words: aneurysm • aorta • diagnosis • imaging • surgery

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Aneurysms of the aorta are at times evaluated and treated by physicians from a number of specialties. Indeed, whereas cardiac surgeons operate on the ascending aorta and arch and vascular surgeons manage abdominal aortic aneurysms, at present the responsibility often falls to cardiologists to oversee the medical care of patients with aortic disease of all types. However, although formally trained in "cardiovascular medicine," most cardiologists devote their attention to the heart and its coronary arteries, and relatively few have experience in the management of diseases of the aorta. It is therefore important that cardiologists acquire a sufficient knowledge base so that they can confidently evaluate and manage patients with aortic disease and know when it is appropriate to refer them for surgery. Toward this end, the purpose of this review is to summarize the current understanding of thoracic and abdominal aortic aneurysms.

	Thoracic Aortic Aneurysms

 
Thoracic aneurysms may involve one or more aortic segments (aortic root, ascending aorta, arch, or descending aorta) and are classified accordingly (Figure 1). Sixty percent of thoracic aortic aneurysms involve the aortic root and/or ascending aorta, 40% involve the descending aorta, 10% involve the arch, and 10% involve the thoracoabdominal aorta (with some involving >1 segment). The etiology, natural history, and treatment of thoracic aneurysms differ for each of these segments.

View larger version (49K): [in this window] [in a new window]   Figure 1. Anatomy of thoracic and proximal abdominal aorta. (©Massachusetts General Hospital Thoracic Aortic Center. Used with permission.)

Etiology and Pathogenesis
Aneurysms of the ascending thoracic aorta most often result from cystic medial degeneration, which appears histologically as . . . [Full Text of this Article]

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