Thoracic Aortic Aneurysm Indications for Surgery

A board-certified thoracic surgeon and a resident of Tampa, Florida, Dr. Hartmuth Bittner attended the University of Heidelberg Medical School in Germany, where he earned his MD magna cum laude. Subsequently, Dr. Hartmuth Bittner founded Gulf Coast Cardiothoracic Surgery Institute in Tampa, and leads the medical group as president. As part of his work, he is proficient in the repairs and replacement of tricuspid and pulmonary valves and performs surgeries to repair aortic aneurysms.

When patients experience a thoracic aortic aneurysm, an area in the major blood vessel known as the aorta (which conveys blood from the heart to the body) weaken. As blood pushes against the weakened wall of the defective area, that part of the vessel bulges into a balloon-like structure. For some patients, symptoms like cough and hoarseness, back pain, tenderness or pain in the chest, or difficulty breathing persist as the aortic aneurysm swells. In the worst case, which occurs when the condition has become chronic, the vessel wall may dissect (tear), resulting in internal bleeding that may lead to death. If the aneurysm is slow-growing, the wall may never dissect and a patient may never face the aforementioned symptoms or complications throughout their lifetime.

An aneurysm can be treated with surgery, although this is only done when a patient’s condition warrants aggressive intervention. Surgery may be recommended if the aneurysm has grown beyond 5.5 cm in diameter, or a fast growth rate is discovered (typically over 0.5 cm in six months). Such cases have a greater chance of vessel dissection. If the condition is also causing persistent discomfort to the patient, most especially back, side, and/or stomach pain, surgical intervention may be necessary.

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