I was wondering if any Doctor has said anything about 5cm being the limit for enlargement? Only I've heard of patients with 5.2cm still on medication and stable.
Hi
Oh my, where to begin. First let's look at the Aorta, the largest artery in the body. It leaves the top of the left Ventricle after the Aortic valve and travels a short distance upwards (ascending). It then gently curves around to face downwards towards the legs (aortic arch) and then travels downwards through the chest and into the abdomen (descending).
Now the hiatus. When we breath, the large Diaphragm moves up and down to increase/decrease pressure around the lungs in the chest, to draw air in or expel it. If is basically a covering across the inside of the body, in the lower chest and so it needs holes for things to pass through it. For example, there is a esophagal hiatus which is an opening for your food tube to pass through it, so it can get to the stomach which is below the diaghragm. The Hiatus is a ring of muscle, a sphincter, like on the human anus. There is a Aortic hiatus also, where the aorta passes through. The word Tortuous usually refers to a vessel when it is twisty rather than straight. It doesn't mean it is kinked, it is just curved.
So the reports seem to suggest the Aneurysm is affecting the ascending, the arch and descending up to the hiatus. However, from previous reports the enlargement seems pretty stable, so I assume he is on medication which is holding things back. It isn't so much as to how much is enlarged, it's more important how much it is enlarged. Obviously as the vessel enlarges, the walls become thinner, making it weaker and more likely to rupture. They will be keeping an eye on the thickness of the wall and recommend surgery should he be seen as a high risk of rupture.