Aortic Surgery -Traditional and Endovascular

Thoracic aortic aneurysms and dissection

Aneurysms

Depending on the location of the aneurysm treatment will vary.

If the aneurysm is located in the ascending aorta (from heart to the head), it is recommended the aorta be replaced for aneurysms larger than 5-6 cm.  This is performed using traditional incisions, and the replacement used is a fabric graft. 

If the location of the aneurysm is in the descending aorta (through the chest down to feet), traditionally, the aorta is replaced with fabric graft. 

Minimally Invasive Thoracic Endovascular Aortic Repair

The FDA has approved a newer, minimally invasive option that EHMC’s team can offer to eligible patients.  The procedure, endovascular stenting (Endovascular Repair), involves a metal stent that is placed in the artery to exclude diseased portion.  This is done without incisions in the chest allowing quicker recovery.

The long term outcome after surgery for thoracic aortic aneurysms is highly dependent on the cause of the aneurysms and the patient’s condition, i.e. diabetes.

Surgical complications may occur after an aneurysm repair such as bleeding, graft infection, heart attack, irregular heartbeat, kidney damage and stroke.

Dissection

Type A dissections involving the ascending aorta require emergency surgery to repair the aorta.

Type B dissections involving the arch and/or descending aorta, might be treated with medications first.  Usually drugs to lower blood pressure may be prescribed, strong pain relievers, beta blockers which might reduce some of the symptoms.

In some cases the aorta is damaged and needs replacement via either a traditional operation or endovascular approach. The damage can happen over time, therefore it is important to get regular follow-up with a Cardiothoracic Surgeon.

Some of the complications associated with the surgery are: aortic rupture causing shock, bleeding from the aorta, blood clots, cardiac tamponade (compression of the heart that occurs when blood or fluid builds up in the space between the myocardium (heart muscle) and the pericardium (outer covering sac of the heart), stroke, and kidney failure.