Thoracic aortic aneurysm medical therapy

Editor-in-Chief: Amjad AlMahameed, MD, MPH, RPVI, FACP. Beth Israel Deaconess Medical Center and Harvard Medical School. Boston, USA

Medical Therapy
TAA size is the primary indication for repair. Once a TAA reaches a pre-specified size (>5 cm in the ascending aorta, >6 cm in the descending segment) referral for surgical or endovascular repair sholuld be initiated. Most patients undergo repair once they reach >5.5 for ascending and >6.5 cm for descending TAA, respectively.

In certain populations, such as those with Marfan's syndrome, patients with bicuspid aortic valve (especially when AVR is being considered), personal or family history of prior aortic dissection, or those who have been documented on serial imaging studies to have rapidly expanding aneurysms, clinicians would perform repair sooner (size >4-5 cm for ascending and >5.5-6 cm for descending TAAs).