2023 Bryn Mawr Communications II, LLC. I had a private appointment with a cardiologist and asked him lots of questions and it put my mind at rest a bit. 2005;111:816-828. I agree about you being younger but neither of us know how long the aneurysm has been there and might have been there for years, but as you say your has more potential years to grow. With 2 children, ages 39 & 41 and 2 grandchildren, should they be screened if the cause is usually genetic? The upward part of the arch, which is the section closest to the heart, is called the ascending aorta. Only 5.3% of those with a diameter of 40 to 44 mm achieved the theoretical threshold size (55 mm) within 2 years. Symptoms of a thoracic aneurysm may include: Pain in the jaw, neck, or upper back. It seems very different in the USA. This condition develops when the aortic valve is damaged. Get a tattoo or body piercing. If thoracic aortic aneurysms are severe enough to cause symptoms, you may experience severe chest or back pain, shortness of breath, coughing or wheezing, difficulty swallowing, hoarseness, numbness or weakness in one or both arms, and loss of consciousness or low blood pressure. Objective: This study was performed for the determination of the expansion rates and outcomes and for recommendations for the surveillance of the 3.0-cm to 3.9-cm abdominal aortic aneurysm (AAA). And make an appt with cardiologist. Methods of treatment include the following. I changed my activities at the advice of my doctor, which I think prolonged the need for surgery. Aneurysms 5.0 cm to 6.0 cm in diameter have a 3% to 15% risk of rupture within one year; those 6.0 cm to 7.0 cm have a 10% to 20% risk, those 7.0 cm to 8.0 cm have a 20% to 40% risk, and aneurysms . But sometimes people have no symptoms at all. Risk of a sudden rupture These are the main factors that make a rupture more likely: The aneurysm is larger than 5.5 cm in diameter. Davies and colleagues followed 304 patients with unoperated thoracic aortic aneurysms (dissection free at presentation) with aortic diameters 3.5 cm, for a . Nonetheless, when the size of an aneurysm is greater than 5 centimeters, the only way to attend to it is through surgery. 2011;53:1499-1505. (based upon risk assessment) diameter indicates increasing danger because they're harder to detect before too much damage has been done! The aorta carries blood from your heart to your abdomen, legs, and pelvis. We and our partners use cookies to Store and/or access information on a device. Unfortunately, there is no consensus or evidence that one criterion or composite of features precisely define such a group or predict within what time frame after diagnosis they are most susceptible to all-cause mortality. Patients with endoleaks that sealed and low flow Abdominal Aortic Aneurysm. An aortic aneurysm is a balloon-like bulge that affects the aorta, the main artery that carries oxygen-rich blood directly from the heart to smaller blood vessels in your body. It happens when the artery wall weakens. How Dangerous Is A 4 Cm Aortic Aneurysm The aortic aneurysm is the most dangerous of all vessel diseases. A cerebral aneurysm (also known as a brain aneurysm) is a weak or thin spot on an artery in the brain that balloons or bulges out and fills with blood. Privacy Policy|Advertising Policy|Privacy Preferences Center|Do Not Sell My Personal Information. I had been seen in a large local hospital and asked the consultant why the op could not be done there- she said, tactfully, "it would be in your best interests to go to the Heart Hosp.". It leaves the heart and forms an arch. I had surgery 5/20/16 for a TAA repair. And the risk increases significantly when the diameter of the bulge exceeds 5.5 cm (more than 3 cm is considered an aortic aneurism, and 4 cm indicates "clinical significance"). Take illicit drugs. Expansion rate of descending thoracic aortic aneurysms. Patients undergoing open repair also had a more than twofold risk of developing spinal cord ischemia across these studies. An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso. In a person with no symptoms, if the AAA is 4.0 to 5.5 cm in diameter, treatment depends on several factors, including: The size of the aneurysm If the aneurysm is expanding If there are symptoms If there are aneurysms in other blood vessels A person's surgical risk Egton Medical Information Systems Limited. I am hoping if I can hang out for a few more years they will have developed a stent to fix it without the requirement for open heart surgery like they have for the lower down ones, that would be good. Nevertheless, thoracic aneurysms feature a distinct pathobiology, as they are characterized by medial necrosis and mucoid infiltration, as well as elastin degradation and vascular smooth muscle cell apoptosis. The one-year incidence of rupture is 9 percent for aneurysms 5.5 to 6.0 cm in diameter, 10 percent for 6.0 to 6.9 cm, and 33 percent for AAAs of 7.0 cm or more. Thoracic aorta. The aneurysm can burst completely, causing bleeding inside the body. However, varying degrees of degeneration can be seen in patients without these disorders, occurring as an idiopathic variant in familial syndromes or as an acquired form. These include longer delivery systems and more accurate deployment systems (necessary in tortuous anatomy with very high blood flow and exceptionally large forces and motion). I was diagnosed with the same condition four years ago when I was 64. The aneurysm is growing quickly, 0.5 cm or more over 6 to 12 months, regardless of its size. What should you not do with an aortic aneurysm? and Privacy Policy and steps will be taken to remove posts identified
Closer to the heart, a thoracic aortic aneurysm diagnosis is based on the persons age, sex, and which part of the thoracic aorta is measured. [13] The bicuspid bit is genetic it seems. The dilatation is continuous and gradual. The overall surgical mortality for an elective open TAA repair is 5% to 9%.5,6 In the last decade, we have seen a significant decrease in open procedures for TAAs. I'm in a lot if stress. Current guidelines for repair suggest the threshold for prophylactic surgical aortic repair to be within the range of 5.5 to 6 cm, but the decision regarding which individual will benefit from repair remains challenging. (2017). . Davies RR, Gallo A, Coady MA, et al. Pivotal results of the Medtronic vascular Talent thoracic stent graft system: the VALOR trial. I have an Abdominal Aortic Aneurysm measuring 2.5 x 2.14 CM proximal, mid aortic measures 4.0 x 3.6 CM , the distal aorta measures 5.0 x 4.7 CM. Our articles are resourced from reputable online pages. 2010;252:603-610. 3. Im 53 yr female and I have just been diagnosed with a thoracic ascending aortic aneurysm of 4cm, still in shock as I never expected it, as I'm not a smoker, neither a drinker, doesn't run in the family. The shortfall in long-term survival of patients with repaired thoracic or abdominal aortic aneurysms: retrospective case-control analysis of hospital episode statistics. Knyshov GV, Sitar LL, Glagola MD, Atamanyuk MY. He or she will also consider the location of the aneurysm, any symptoms, your age, and other health conditions to determine the need for any further treatment. An aortic aneurysm occurs when the aorta's wall is torn open. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. 28. I find when I do have an appointment with him it is very rushed so it was worth the money. doi: 10.1016/j.jvs.2017.10.044. Dividing patients into high- or low-risk groups would be very helpful to identify who may or may not benefit from early intervention. Recovery After Aortic Aneurysm Repair: What to Expect, An ideal
Cardiol Young. Read our editorial policy. In terms of restrictions on activity, we agree with the 2010 multidisciplinary guidelines for managing patients with thoracic aortic disease [Hiratzka et al. Eagleton M. (2017). Along with the size, AAA rupture risk depends on the rate, by which aneurysm expands. False aneurysms are different but are nevertheless not an uncommon presentation of thoracic aortic disease. Perko MJ, Norgaard M, Herzog TM, et al. According to my dr that's possible. The aneurysm ha read more Lane, PhD, BSc, MBBS, MRCS; Sadie Syed, MD, MBBS, FRCA; Richard Gibbs, MD, MBChB, FRCS; and Colin D. Bicknell, MD, FRCS, left-arrow Generally, about 2.3 inches (6 cm) is the critical size for atherosclerotic aneurysms. An aneurysm is a bulge that forms in the wall of an artery. Population-based outcomes of open descending thoracic aortic aneurysm repair. Survival after open versus endovascular thoracic aortic aneurysm repair in an observational study of the Medicare population. The normal ascending aorta is no more than 3.5 cm in diameter. The aorta is the large blood vessel that the heart pumps into via the aortic valve every time it beats. Help Millions of people find the right doctor and care they need, Get immediate care and visit with providers from the comfort of your home, or anywhere, Urgent care centers can be faster and cheaper for situations that are not life threatening, Doctors and patients discuss the latest medical treatments and health tips, Search prescription drugs for why theyre used, side effects and more, Back and Neck Surgery (Except Spinal Fusion), https://my.clevelandclinic.org/treatment-guides/14-0028-aortic-aneurysm-treatment-guide?_ga=2.207135571.1301545328.1606747543-1151960348.1604337613, https://www.nhlbi.nih.gov/health-topics/aneurysm, https://www.cdc.gov/heartdisease/aortic_aneurysm.htm, https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/abdominal-aortic-aneurysm.html, https://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/abdominal-aortic-aneurysms-aaa, https://pubmed.ncbi.nlm.nih.gov/29268916/. Family history: About 20 percent of all thoracic aneurysms develop in people with a family history of thoracic aneurysms. Sinus of Valsalva aneurysm (SOVA) is an abnormal dilatation of the aortic root located between the aortic valve annulus and the sinotubular junction. Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial. 30. An aneurysm is a weak spot in a blood vessel wall. In some patients with connective tissue disorders or Marfan syndrome those who suffer from these conditions may develop crippling tears early on before their condition has progressed too far for treatment by medical professionals For patients with aneurysms secondary to connective tissue disorders, the recommended threshold for repair is an aneurysm diameter exceeding 50 mm. Doctors also call an aortic root aneurysm a dilated aortic root. Ann Thorac Surg. 24. These cases tend to develop in younger people. An abdominal aortic aneurysm is also called AAA or triple A. How Game of Thrones Actress Emilia Clarke Survived Two Aneurysms, Glycemic Index: What It Is and How to Use It. Like most arteries, the aorta is elastic, which allows it to be filled with blood under high pressure. Read More Created for people with ongoing healthcare needs but benefits everyone. Endovascular interventional endovascular grafting for treatment of aortic aneurysms has been used in the world for the past 2-3 decades and Vietnam several years ago to effectively treat aortic aneurysms. Multiple factors, rather than a single process, are implicated in the pathogenesis of TAA. Each of these complications mentioned here are of limb as well as life-threatening ones and when doctors diagnose them, they indicate for the requirement of repair or surgery. 2010;140:1001-1010. The initial surgery itself was interesting and the recovery process is too. Therefore, guidelines have suggested that repair is appropriate for saccular aneurysms > 2 cm or saccular aneurysms associated with a total aortic diameter > 5 cm.16, The latest ESVS guidelines suggest that based on the size differential between men and women at baseline, the threshold can be reduced to 50 to 55 mm for women. While treatment for a small aneurysm is not always necessary, its important to keep a watchful eye on it. The more serious side effects include heart problems due to interruption between your spines blood flow and nerves that control muscles down below; infections at sites where there was open tissue removal during surgery (this includes local wound healing); swelling around areas Vishnu Siva wrote about but didnt go into detail on because they were less relevant than others like kidney function loss which could lead you towards needing dialysis therapy eventually. If symptoms are present, they may include: If the aorta ruptures, youll feel a sudden, sharp pain in your chest that extends to your back, between your shoulder blades. All 13 families had multiple affected members, often in more than 1 generation, consistent with an autosomal dominant pattern of inheritance. have had chest pains, for months,..went to a boston hospital, had a catherization,..& had 2 stents put in, had a heart attack, & 2 100% blocked arteries. I have only radiologist's report which says "There has been mild interval increase in size of the ascending aortic aneurysm, fusiform dilatation being seen through 8-9 cm above the valve plane with maximum AP dimension of 5.2 cm compared with measurements of 4.8 cm on previous exam (Feb. 2011 which then actually was reported as 4.7 cm). How long can u live with an aortic aneurysm? The aneurysm is causing symptoms such as pain in the back, stomach . Three in four aortic aneurysms are AAAs. Thoracic Aortic Aneurysm or Thoracic Aneurysm and Aortic Dissection (TAAD): Causes, Signs, Symptoms, Treatment, Home Remedies. Nonetheless I have stopped fussing over it and it hasn't grown anymore. The aorta is the body's largest blood vessel. When ascending aortic aneurysms meet the size criteria or co . Weston Vascular Network (2011). Aneurysms are dangerous because they can rupture, causing internal bleeding. An aneurysm that is less than 5 cm may be monitored without surgery. A small 4 cm sized aneurism has very little chance or likelihood for bursting, but larger 5+ inch dia. Otherwise known as an aortic root dilatation, when the first section of your hearts main pipeline where youll find its valves begins to grow larger than normal this can be dangerous and lead into life-threatening situations if not treated quickly enough. Aortic aneurysms are small bulging blood vessels in the artery that runs through your neck. There may be swelling around the tear, causing pain in different parts of your body. 16. 2007;50:209-217. The content on Healthgrades does not provide medical advice. Nobody used the word aneurysm or even mentioned it to me at the time. Medications to bring down your blood pressure include beta blockers, which also slow your heart rate, and angiotensin receptor blockers (ARBs). This will help control your blood pressure as well as your cholesterol levels. Eur J Vasc Endovasc Surg. i was diagnosed with a 4.3, annerysm in dec, 2months ago. If you have an aneurysm, be sure to follow your doctors advice about medications and follow-up exams. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. Treatment options An aneurysm that is less than 5 cm may be monitored without surgery.. Use of the forums is subject to our Terms of Use
I am not on any medicines at all. The reported 30% to 50% short-term mortality in patients with aortic aneurysm diameters >6 cm was, until fairly recently, the basis for recommendation of elective aortic surgery at 6 cm. What is a Thoracic Aortic Aneurysm (TAA)? I believe the CT scan is considered the most accurate. I'm thinking of getting a second opinion soon though. Background: The risk of rupture of large abdominal aortic aneurysms (AAAs) remains uncertain. Thoracotomy, aortic cross-clamping, and partial cardiopulmonary bypass are associated with long operating times and major blood loss and are responsible for a considerable number of surviving patients who suffer from disabling complications such as permanent paraplegia or stroke.21,22 There is evidence that TEVAR offers a less invasive alternative for the management of descending thoracic aortic pathologies. Bahia et al revealed that AAA patients with appropriate risk factor modification can significantly reduce their long-term mortality.27, Unfortunately, there are no trials that comprehensively analyze the natural history of TAA (like the EVAR 2 trial for AAA). Aortic Aneurysm. You are off to a good start by searching for information on the subject. National Heart, Lung and Blood Institute. A diameter greater than 3.5cm is considered to be an aortic aneurysm. God bless you are over it now, what was your experience? hello Gigi, thank you so much for your msg. Heres what some top doctors have to say about high cholesterol, or hyperlipidemia. 2006;81:169-177. I would be so thankful if you all can provide some additional information. Patient does not provide medical advice, diagnosis or treatment. In this procedure, a surgeon opens up your chest and replaces the damaged portion of your aorta with a synthetic tube called a graft. Signs and symptoms that an aortic aneurysm has ruptured can include: Sudden, intense and persistent abdominal or back pain, which can be described as a tearing sensation Low blood pressure Fast pulse Aortic aneurysms also increase the risk of developing blood clots in the area. Lancet. If you have Marfans syndrome, your ascending aortic aneurysm should be repaired once it reaches 4.5 cm in diameter. Stanford Healthcare. In addition to troubling symptoms, the condition can take a mental toll. I'm a European citizen living I the United Arab Emirates in Dubai at the moment and this is not a surgery someone would like to do in Dubai. Wow I suppose it's a very big surgery! (2017). They become more common with every decade of age. Elefteriades JA. Primary form of aortoentric fistula or an abnormal connection in between the bowel and the aorta, Thromboembolism i.e. Diehm N, Dick F, Schaffner T, et al. The aneurysm has grown quickly (more than 0.5 cm in six months or more than 1 cm in one year). 1996;61:935-939. The relative survival percentage remained steady at about 87%. Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the Gore TAG thoracic endoprosthesis. Asked by: Jacey Braun Score: 4.6/5 (22 votes) . In 6months. Aneurysm may takes place in almost every area present in aorta, but abdominal area is the common one. Patterson BO, Sobocinski J, Karthikesalingam A, et al. Next Article 2016;102:817-824. Paul Hollering A thoracic aortic aneurysm refers to the part of the aorta that runs through the chest. I am in the UK by the way. It helps though when realize I'm not the only one. Most of the patients have relatively longer periods with lesser changes in the size of aneurysm. This was my own decision because I reckon if I need it done at some point I would like to know who was doing it in advance and be sure I had confidence in that person and I am very happy I have found the right person. Risk of aneurysm rupture annually depends on its specific size, according to which- Less than diameter of 4cm has a risk of less than 1 among 200 in total Diameter between 4cm and 4.9cm have risk between 1 in total 200 and 1 in total 20 Diameter between 5cm and 5.9cm have risk between 1 in total 30 and 1 in total 7 Hello Sonia, thank you so much for the information, I'll keep this in to my list. upmc.com/services/heart-vascular/conditions-treatments/pages/ascending-aortic-arch-aneurysm.aspx, vascular.org/patient-resources/vascular-conditions/thoracic-aortic-aneurysm, mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/diagnosis-treatment/treatment/txc-20122075, escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-10/Ascending-aortic-aneurysms-pathophysiology-and-indications-for-surgery, my.clevelandclinic.org/health/articles/thoracic-aortic-aneurysm/symptoms-diagnosis, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. . THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. Like you, I was in such shock because I only went for an echo as I had been having some irregular beats. Treatment options may include: Open. National trends and regional variation of open and endovascular repair of thoracic and thoracoabdominal aneurysms in contemporary practice. The aorta is the main blood vessel that carries blood from the heart to the rest of the body. PMID: 29268916. aorta dilate or bulge. Size of the aneurysm is considered a strong predictor of rupture risk. Evidences have suggested that expansion of aneurysms takes place at the average rate from 0.3cm to 0.4cm yearly and tends to expand at the fastest rate as compared to any small aneurysm. Aortic aneurysms can occur anywhere in the aorta and may be tube-shaped (fusiform) or round (saccular). Gopaldas RR, Huh J, Dao TK, et al. Ann Thorac Surg. It will need surgery coming closer to 5cms. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers. Usually, surgical repair is necessary once an aneurysm reaches 5 centimeters (cm) in diameter. Youre also at higher risk of an ascending aortic aneurysm if you have aortic valve disease. The thoracic aorta begins where the left ventricle ends at the aortic valve and continues down through the chest. Expansion rates and outcomes for the 3.0-cm to the 3.9-cm infrarenal abdominal aortic aneurysm AAAs of 3.0 cm to 3.9 cm expanded slowly, did . Usually, surgical repair is necessary once an aneurysm reaches 5 centimeters (cm) in diameter. Svensson LG, Crawford ES, Hess KR, et al. This article does not provide medical advice. An ascending aortic aneurysm is often found during a routine checkup or an examination ordered for another condition. Novel measurement of relative aortic size predicts rupture of thoracic aortic aneurysms. and no plaque. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. Eur J Vasc Endovasc Surg. particularly those suffering from connective tissue disorders like Marfan syndrome who might not show any symptoms until their disorder has progressed significantly enough so that it could cause significant injury on its own without intervention; providing warning signs include tall height due in part genetic makeup coupled how easily injured people typically tend grow over, The study found that short-term crude or actual survival rates improved among patients who had surgery to repair a ruptured abdominal aortic aneurysm. All Rights Reserved Privacy Policy, Robert J. Hinchliffe, MD, FRCS; Paul Hollering. Centers for Disease Control and Prevention. Dissection greatly increases the risk of rupture and reduces blood flow to the rest of the body. If you and your doctor agree that a watch-and-wait approach is best, you may be placed on medications to help lower your blood pressure and cholesterol. Im 53 yr female and I have just been diagnosed with a thoracic ascending aortic aneurysm of 4cm,still in shock as I never expected it, as I'm not a smoker, neither a drinker, doesn't run in the family. Ann Thorac Surg. Approximately 60% of TAAs occur in the root or ascending aorta, 10% in the arch, 40% in the descending aorta, and 10% in the thoracoabdominal aorta, with some aneurysms involving multiple aortic segments.3. In the MOTHER database of 1,010 patients undergoing TEVAR (an amalgamation of device-specific Medtronic registries, which include TEVARs performed for a range of pathologies), increasing age was an independent predictor of 30-day mortality, with an odds ratio of 1.05 per additional year of age.25, It would be useful to determine who is not likely to achieve an overall benefit from having their aneurysm repaired. 23. Comparison of the effect on long-term outcomes in patients with thoracic aortic aneurysms taking versus not taking a statin drug. Learn how we can help 4.6k views Answered >2 years ago Thank A 50-year-old female asked: Chances Of Getting Pregnant From Pulling Out. family history, ( on my mom's . All rights reserved. The aorta behaves similarly to a rubber band. Abdominal aortic aneurysms (AAAs) account for three fourths of aortic aneurysms and affect 0.5 to 3.2% of the population. as being in breach of those terms. We avoid using tertiary references. However I am glad that it was found, because I get tested regularly and if it got worse action would be taken. Conrad MF, Ergul EA, Patel VI, et al. Doctors diagnose an abdominal aortic aneurysm when the diameter within the aorta is 3 cm (centimeters) or greater. Brown LC, Powell JT. Achneck HE, Rizzo JA, Tranquilli M, Elefteriades JA. A weakening of the artery wall in this region is called a thoracic aortic aneurysm. Risk of a sudden rupture These are the main factors that make a rupture more likely: The aneurysm is larger than 5.5 cm in diameter. An abdominal aortic aneurysm surgery becomes dangerous only if the patient is suffering from additional risk factors. Was 48 when I was diagnosed with both. Patient is a UK registered trade mark. Are you ok now? abdominal aortic aneurysms in general does not create any form of health issue. Only have mri once a year now. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. I am very well and keep fit in case I need it done. Aortic dissection is a devastating disease that threatens life without premonitory signs. American Family Physician. Always speak to your doctor before acting and in cases of emergency seek
Prog Cardiovasc Dis. Stenosis occurs when the opening to the mitral valve is narrowed. Incidence of descending aortic pathology and evaluation of the impact of thoracic endovascular aortic repair: a population-based study in England and Wales from 1999 to 2010. I did go to the bother of trawling through old medical records and I found an echo which had been done when I was 31 that showed widening of 3.2 cms. There are some promising developments, such as molecular imaging and new insights in medical therapy, that may also help in this process when they become available for clinical use. 25. appropriate medical assistance immediately. I had a follow up CT scan and then an MRI. Bulging can occur in any artery in your body. HI Moreen, thank you so much for taking the effort to answer to my msg. Both showed the aneurysm to be 4.1 whereas the echo had stated 4.6. If there is no change I won't need the expense of the appointment. Open surgery to repair an aneurysm can require a recovery time of about a month. 10. Design: The study was observational with data from patients screened with ultrasound scanning for AAA at five Veterans Affairs Medical Centers for enrollment in the Aneurysm Detection and Management . All Rights Reserved. Other TAAs are those that result from aortic dissection or acute aortic syndrome or are associated with anatomic variants such as an aberrant left subclavian artery (Kommerell diverticulum). Safety of thoracic aortic surgery in the present era. An unrelated infection caused a few missed beats which the doctor decided should be checked with an echo just because I was in hospital anyway. Monitoring the biological activity of abdominal aortic aneurysms beyond ultrasound. As aneurysms grow larger, the vessel wall gets weaker and may eventually rupture or split (dissect), which can be life threatening. Data from Yale have described the incidence of rupture and dissection as a function of initial aneurysm size and that the risks of these events increase with greater aneurysm diameter.14 Further analyses revealed that baseline aortic diameter was the only significant risk factor for adverse aortic events, with a hinge point of aortic diameter around 60 mm, while the yearly rate of serious aortic complications increased exponentially from 10% at 6 cm to 43% at 7 cm.14 Based on these findings, the authors suggested the threshold of 5.5 to 6 cm for prophylactic surgical aortic repair.