Question: I have been diagnosed with aortic aneurysm (fusiform). I have a genetic bicuspid aortic valve. The size of my aortic arch is about 5 cm. The rest of my thoracic region aorta is measured at about 4.5 to 4.8 cm. At what size is thoracic surgery indicated?

Dr. Hibberd's Answer:
Aneurysms of the aorta are weak areas that form in the blood-vessel wall that balloon out and expand. The general standard for surgical intervention for aortic aneurysm is diameter of 5 cm or more. It's advisable to consult with a specialist when the aneurysm is discovered, ideally before the surgical threshold has been reached.

Sometimes the expansion occurs very rapidly, and on occasion they may break inside the wall forming a dissection that converts this situation into a surgical emergency. The concern is that the dissection may knock out adjacent blood vessel connections and hence the blood supply to the organs and tissues supplied by these branch vessels. If you have an aneurysm, be sure to follow the advice of your vascular or cardiovascular surgeon.