Massive ascending thoracic aortic aneurysm
Congestive heart failure.
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Massive fusiform ascending aortic aneurysm involving the root/sinuses of Valsalva, 8.8 cm AP.
Left ventricular dilation.
While undiagnosed, this patient almost certainly has an underlying connective tissue disorder to account for the formation of his massive aneurysm at such a young age (such as Marfan, Ehlers Danlos, or Loeys Dietz1). No evidence of rupture. Ectasia of the brachiocephalic artery supports a connective tissue disorder.
For aneurysm greater than 6 cm, the risks are as follows:
- rupture 3.7% per year
- rupture or dissection at 6.9% per year
- death at 11.8%
- and death, rupture, or dissection at 15.6% per year2
- (2) Davies RR, Goldstein LJ, Coady MA, Tittle SL, Rizzo JA, Kopf GS, Elefteriades JA. Yearly rupture or dissection rates for thoracic aortic aneurysms: simple prediction based on size. (2002) The Annals of thoracic surgery. 73 (1): 17-27; discussion 27-8. doi:10.1016/s0003-4975(01)03236-2 - Pubmed
- (1) Cury M, Zeidan F, Lobato AC. Aortic disease in the young: genetic aneurysm syndromes, connective tissue disorders, and familial aortic aneurysms and dissections. (2013) International journal of vascular medicine. 2013: 267215. doi:10.1155/2013/267215 - Pubmed