A Perspective on Natural History and Survival in Nonoperated Thoracic Aortic Aneurysm Patients.

Mohamad Bashir,Matthew Shaw,Ibrahim Hammoud,Manoj Kuduvalli,Matthew Fok,Aung Oo,Lara Rimmer,Debbie Harrington,Mark Field

doi:10.12945/j.aorta.2013.13-043

Abstract

There are many questions that remain unanswered in the understanding of the natural history of thoracic aortic aneurysm (TAA). This review will critically appraise the current published evidence on the natural history of TAA in nonoperated patients and their present rates of survival.

Highlights

We aim to demonstrate in this review the published evidence pertaining to survival among nonoperated or nonintervened thoracic aortic aneurysm cohorts
Understanding the natural history of a disease is critical in managing patients, and this review demonstrates why this is of such importance in thoracic aortic aneurysm (TAA)
Some facts remain accepted about TAAs: first, that untreated TAAs remain a deadly disease with a very poor prognosis; second, that prognosis varies with TAA location in either the ascending or descending aorta; third, that increasing aneurysm size correlates with increasing aneurysm growth, risk of rupture and risk of death; and, that a dissection in the presence of a TAA heralds a poor prognosis

Summary

Introduction

We aim to demonstrate in this review the published evidence pertaining to survival among nonoperated or nonintervened thoracic aortic aneurysm cohorts. Search terms included natural history, thoracic aortic aneurysms, aneurysm size, risk factors, survival rates, medical therapy, aneurysm growth, dissection, rupture, and mortality. Earlier surgical intervention is advocated for Marfan’s disease and other genetic syndromes compared to TAA of other etiologies, as aneurysms in these patients tend to rupture or dissect earlier [12].

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Conclusion