Aortic aneurysm care in San Antonio
The heart and vascular specialists at Methodist Healthcare offer first-class treatment for aortic aneurysms, including thoracic aortic aneurysms and abdominal aortic aneurysms (AAAs), and other conditions affecting the aorta, like aortoiliac disease. Our doctors have years of experience in treating vascular conditions and are specially trained in performing life-saving surgeries.
To learn more about treatments we offer for vascular conditions, like abdominal aortic aneurysm, call the Methodist Healthcare HealthLine at (210) 575-5506.
Methodist Healthcare’s vascular doctors offer the most comprehensive vascular disease treatment in San Antonio, with convenient locations throughout South Texas. Additionally, we offer patients access to extensive cardiac care services, including heart and vascular surgery and cardiac rehabilitation.
Methodist Aortic Center
Methodist Aortic Center, a facility of Methodist Healthcare located within Methodist Plaza, offers advanced specialty heart services for patients throughout Greater San Antonio with an aortic aneurysm. Our cardiologists perform the most current heart and vascular surgeries and offer comprehensive treatments for both abdominal and thoracic aortic aneurysms.
What is an aortic aneurysm?
An aortic aneurysm is an abnormal enlargement of the wall of the aorta that causes the walls to weaken. The aorta is the major blood vessel that carries blood from your heart to your body.
The aorta is a tube that is about a foot long and over an inch in diameter. The ascending portion of the aorta rises about two inches from its exit point on the left ventricle and gives off branches to supply the heart. It then curves downward giving off branches that supply blood to the head, neck and arms.
Aneurysms can occur anywhere along the aorta and, in some cases, an individual may have both types of aneurysms:
- Abdominal aortic aneurysm—This type of aneurysm occurs through the portion of the aorta that passes through the abdomen
- Thoracic aortic aneurysm—This type of aneurysm occurs through any portion of the aorta that runs the entire length of the chest, which supplies blood to structures in the chest. This type of aneurysm usually grows slowly and does not present with symptoms, which can make it very challenging to detect.
The wall of the aorta can continue to enlarge or remain unchanged. It is important to monitor aortic aneurysms closely. If the bulge continues to grow, the wall can become weakened and cause tearing, or dissection, and life-threatening bleeding.
Symptoms of an aortic aneurysm
Because aortic aneurysms take a long time to develop, symptoms are rarely felt until they become serious health concerns. Symptoms usually manifest when the aneurysm compresses on surrounding structures and can cause:
- Chest pain
- Back pain
- Difficulty breathing
- Difficulty swallowing
You may be experiencing a tearing of the aorta if you are experiencing:
- Sudden chest pain or back pain
- Pain in the jaw and neck
- Nausea and vomiting
- Raising heartbeat
- Dizzy or generally feeling unwell
Other signs and symptoms that suggests aneurysm rupture, or burst, include:
- Low blood pressure
- Loss of consciousness
- Weakness/difficulty speaking
- Signs of stroke
If you are experiencing symptoms related to tearing or rupturing of an aneurysm, seek immediate medical evaluation at the nearest emergency room.
Risk factors and causes of aortic aneurysm
The following lifestyle choices, events, genetic traits and conditions can contribute to causing an aortic aneurysm:
- Long-term tobacco use, including smoking
- Traumatic injury
- Degenerative disease of the aortic wall that is related to aging
- Atherosclerosis or plaque build-up in the walls
- Genetic conditions, such as Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome and Turner syndrome
- Inflammatory conditions, such as giant cell arteritis and Takayasu's arteritis
- 65 years old or older
- Family history of cardiovascular diseases
Aortic aneurysm diagnosis
Due to its lack of definitive symptoms, many aortic aneurysms are found during an examination of a different condition. For example, an aortic aneurysm may be found during a chest X-ray or an ultrasound of the heart. If your doctor suspects you may have an aortic aneurysm forming, specific diagnostic tests can be performed for confirmation, including:
- Abdominal ultrasound
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
Aortic aneurysm treatment
The goal of treatment is to prevent an aneurysm from growing or rupturing. Medication and monitoring are important interventions prior to surgical repair.
Monitoring may require regular imaging studies to detect the rate of growth of the aneurysm. A computed tomography (CT) scan or magnetic resonance angiogram (MRA) should be conducted every six months depending on cause, size and rate of growth of the aneurysm. Medications may be prescribed to help control blood pressure and reduce cholesterol levels.
Surgery is recommended based on the size and location of the aneurysm and its rate of growth. Surgical repair is generally recommended if your thoracic aortic aneurysm is between five or six centimeters or larger.
Patients with Marfan syndrome or other connective tissue diseases, who have a higher risk of having an aortic dissection, may need to undergo repair for smaller-sized aneurysms.
Surgical treatments may include:
- Open-abdominal procedure—This procedure involves making an incision above the aneurysm site and temporarily clamping the artery above the aneurysm to stop blood from flowing through the enlarged area. The surgeon then carefully opens up the aneurysm and removes the clotted blood and plaque deposits. After drainage is complete, the surgeon may insert an organic or man-made graft to strengthen the artery wall.
- Endovascular aneurysm repair (EVAR)—Sometimes, a vascular surgeon will suggest that you get a stent graft for your aneurysm if it has not ruptured. An endovascular stent graft is a tube composed of fabric supported by metal mesh that strengthens the weakened section of your artery. This allows blood to flow normally through the artery without putting pressure on the bulge, eliminating the risk of the aneurysm rupturing.
Methodist Aortic Center offers services at the Methodist facility located in the Medical Center. It serves all of South Texas providing patients treatment plans from critical to advanced therapy measures to those who have been diagnosed with an aortic aneurysm to reduce the need for surgery.
What to expect
Each patient will have a specific treatment plan provided based upon their stage of aneurysm and their medical history. It will take on average about two to three months to achieve full recovery after undergoing ascending aortic aneurysm/dissection or arch surgery. Your surgeon will advise you to plan to be away from work for six to eight weeks with some post-operative restrictions for activities. We encourage participation in a cardiac rehabilitation program during your recovery period. Arrangements can be made for these services prior to your discharge home.
Remember to make lifestyle changes even after surgery such as eating well and subscribing to a healthy diet, smoking cessation, and engaging in moderate physical activity. There are no medications to prevent the development of an aortic aneurysm but controlling blood pressure and cholesterol levels may reduce the risk of complications from an aortic aneurysm.
The surgeon will follow the patients 3, 6, 9 months - then decrease visits and have their primary care physicians or Cardiologist continue the follow up care.
- Post-operative restrictions will differ from patient to patient. Your surgeon will advise you on these restrictions before discharge.
- Participating in a cardiac rehab program is strongly recommended.
- Daily walking is a good way to regain strength and improve your energy levels.
- Eating healthy, incorporating fruits, vegetables and whole grains in your diet will help in your recovery.
- Habits including smoking and alcohol use should be eliminated.