Thoracic aortic disease

Abstract

The incidence of aortic pathology is increasing at an alarming rate, with no identified reasons for this trend. According to the Center for Disease Control and Prevention, aortic aneurysms are the 15th most common cause of death in individuals older than age 65 years. The majority of aortic diseases are silent and lack clear pathognomonic symptoms that would make their timely detection easier for the physician. Because of the silent nature of thoracic aortic aneurysm, devastating complications such as aortic dissection and rupture often prove a lethal first manifestation. Thoracic aortic aneurysm is largely a genetic disease with strong familial inheritance. Although a virulent disease, thoracic aortic aneurysm is an indolent process with the aortic growth rate of approximately 0.1 cm/year. This chapter discusses the current understanding of the pathophysiology of thoracic aortic diseases, the current diagnostic approaches, and up-to-date management strategies based on recent guidelines and published literature.