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8cm Thoracic Aortic Aneurysm(Need Expert Suggestions)
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8cm Thoracic Aortic Aneurysm(Need Expert Suggestions)

Here is my grandfather’s case

Doctor Consultant Report
Summary:
Age: 83y
Sex: M
walk with stick ,ex-smoker ,non drinker, live with family
hoarseness for around 4 months
CXR: aortic aneurysm
ECG: fast AF
sCr 168 on admission

CT brain: chronic ischaemia

imp:
1.      HT/CRF/ right renal artery stenosis with fast AF
2.      hoarseness? related to aortic aneurysm

consulted ENT  L VC palsy

urgent CT thorax with contrast done
Impression
1.      8.0cm aortic arch aneurysm distal to the origin of left subclavian artery. Mixed hyper- and hypo-dense intra-mural density, suspicious of subacute intra-mural hematoma. No CT evidence of dissection or rupture.
2.      Atrophic right kidney with narrowed right renal artery, suspicious of right renal artery stenosis

all along no chest pain/back pain

Suggest arrange urgent USG carotid doppler and echo bedside echo today

In AF, normal LV size, dilated LA(4.3cm) and aortic root (~3.7-4cm)
mild to mod AR, mild TR/MR, RVSP 35mmHg
overall impaired LVEF 40%with septal hypokinesia
no pericardial effusion

pending urgent USG carotid Doppler


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2 Comments
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Avatar_m_tn
Here is his CT report

CT report
Examinations: contrast CT Thorax
Report:
Clinical History
left mediastinal mass

Clinical Diagnosis
AF

Contrast CT Thorax
A few hypodense lesions are noted at the thyroid. The largest one measures 3.4cm at left lobe of thyroid
Aortic aneurysm at the arch aorta just distal to the origin of left subclavian artery is seen. It measures ~8.0cm in diameter. Mixed hyper – and hypodense intra-mural density is noted, which is most prominent at the left lateral aspect. In view of pre-contrast hyperdensity , subacute intra-mural hematoma has to be considered. DDx would be intra-mural thrombus.

No intimal flap is seen. No false lumen is appreciated. No active contrast extravasation.

The ascending aorta and descending aorta is not dilated. Abdominal aorta is unremarkable

Cardiomegaly. No pericardial effusion.

Lungs are clear. A0.7cm calcified granuloma is noted at left upper lobe

No pleural effusion.

Trachea and major bronchus are patent.

Liver, spleen, adrenals and pancreas are unremarkable.

Atrophic right kidney. Abrupt termination of contrast in the right renal artery near the origin from aorta is noted. Faint opacification of the proximal renal artery is demonstrated. Features is suspicious of renal artery stenosis.

Simple cortical cysts are noted at left kidney.

No aggressive bony lesion.

Impression
1.8.0cm aortic arch aneurysm distal to the origin of left subclavian artery. Mixed hyper- and hypo-dense intra-mural density, suspicious of subacute intra-mural hematoma. No CT evidence of dissection or rupture.
2.Atrophic right kidney with narrowed right renal artery, suspicious of right renal artery stenosis  



My grandfather get Thoracic Aortic Aneurysm, After consultant doctor said he didn’t know why aortic aneurysm the extend to 8cm. He only provide two suggestions to us
1.Take drugs only , but he forecast he will 50% chance  ‘disappear’ in the year.  
2.Surgery. But he warning because my grandfather high blood pressure, heart weakness and poor kidney function. The successful rate around 60-70%only.

We just want choose the best to he

Please give us suggestions

Thanks for your suggestion!


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Avatar_n_tn
Hi there,

I'm not the doctor but want to wish you, your family and your grandfather the very best.  I have an aneurysm of the ascending aorta measuring 4.5 cm (as well as aneurysms in the origins of the great vessels) and that's scary enough to deal with. I can't imagine an 8.0 cm., especially when from everything I've read surgery is suggested at 5.0 cm.  

Again, positive vibes and all the best in what is a very difficult situation.
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