Thoraco-Abdominal Aneurysms (TAA)

What is a Thoraco-Abdominal Aneurysm?
Anatomy & Terminology
Clinical Research & Applications
For Additional Information / To Make an Appointment

What is a Thoraco-Abdominal Aneurysm?

Aneurysms that involve the thoracic and abdominal aorta are called thoraco-abdominal aneurysms and are an uncommon entity. Historically, the problems associated with the repair of these aneurysms have been relatively high morbidity and mortality rates and the risk of paraplegia, which can be as high as 40 percent depending on the extent and cause of the aneurysm.

In 1984, after spending a year working with the late Dr. E. Stanley Crawford of Houston, Texas, Dr. Charles Acher of the University of Wisconsin Department of Surgery and Dr. Mimi Wynn of the University of Wisconsin Department of Anesthesiology established the program for Thoraco-Abdominal Aneurysm Repair in the University of Wisconsin Hospital and Clinics. Their innovative clinical research and application efforts have resulted in a significant reduction of the risks associated with the repair of these aneurysms.

Anatomy & Terminology

These are anatomic illustrations of an actual patient who presented with respiratory failure because the trachea (windpipe) (Figure 1) was being compressed by a very large thoracoabdominal aneurysm (Figure 2). This patient survived the surgery without paraplegia or renal failure and returned to her home (Figure 3).

(Click thumbnail to view larger image)

Figure 1	Figure 2
The parts of the aorta and the branch vessels off the aorta are labeled. The diaphragm separates the thoracic and abdominal portions of the aneurysm.	The accompanying CAT scan image from the patient's initial hospital presentation demonstrates the relationship of the trachea to the aneurysm and other thoracic structures.

Figure 3

The last illustration shows the extent of replacement of the aorta with a Dacron tube graft (new pipe) and how the visceral and renal vessels were reattached. The aorta was replaced from the left subclavian artery to the iliac arteries.

Clinical Research and Applications

Over the past 12 years, clinical research and application efforts at the University of Wisconsin Hospital and Clinics have reduced the risk associated with thoraco-abdominal aneurysm repair. We have developed several unique strategies that have shown significant success in treating patients. With these strategies, we have been able to reduce the risk of paralysis by a factor of 10 in elective patients. We have also been able to significantly reduce mortality for this complex surgery.

The combination of clinical and basic research with the cooperation between the specialized surgical and anesthesia teams has resulted in greatly improved morbidity and mortality rates at the UW Hospital. We have experience treating over 300 patients with this complex disease, and have had excellent results. These improved outcomes clearly result in more functional recovery for these patients and in cost savings in their care.

For Additional Information / To Make An Appointment

If you would like additional information about thoraco-abdominal aneurysms, or would like to make an appointment, contact:

Charles W. Acher, MD
UW Department of Surgery
G5/317 Clinical Science Center
600 Highland Avenue
Madison,WI 53792-7375

Appointments: (608) 263-8915 or (800) 323-8942
Office: (608) 263-1388
FAX: (608) 265-5755
Email: acher@surgery.wisc.edu

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General Surgery University of Wisconsin Department of Surgery
First published: 07/15/02 Last updated: 11/23/09 webmaster@surgery.wisc.edu
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