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Thoracic Aortic Aneurysm Repair

Definition

A thoracic aortic aneurysm repair is a surgery to fix a problem in the aorta. The aorta is the largest blood vessel in the body. It starts at the heart and passes down through the chest and abdomen. The thoracic aorta is the part of the aorta in the chest. The aorta carries blood from the heart to blood vessels that supply the lower body.

This is a major surgery.

Abdominal Aortic Aneurysm
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Reasons for Procedure

An aneurysm is a weakened area of the blood vessel wall. If the aneurysm is large or continues to grow it can make the blood vessel break open. In large blood vessels, this can lead to severe bleeding. A thoracic aneurysm is a weakening of a large blood vessel in the chest called the aorta. Blood passes from the heart to the rest of the body through the aorta. A break in this blood vessel is often fatal.

Surgery may be done if there is a thoracic aortic aneurysm that is large or increasing in size.

Possible Complications

Your doctor will review potential problems, like:

  • Adverse reaction to anesthesia, such as lightheadedness, low blood pressure, and wheezing
  • Soreness in throat
  • Nausea and vomiting
  • Infection
  • Excess bleeding
  • Irregular heart rhythm
  • Kidney damage if blood flow is blocked
  • Heart attack
  • Stroke
  • Paralysis if the spinal cord is damaged

Smoking and heavy alcohol use may increase the risk of problems.

Talk to your doctor about these risks before the procedure.

What to Expect

Prior to Procedure

Before surgery you will be examined and you may also have:

  • Tests of your lung function

Your may also be asked to:

  • Stop eating or drinking anything after midnight the night before your surgery.
  • Stop taking some medications up to 1 week before the procedure.

Let your doctor know about any medications or supplements you may be taking.

Anesthesia

General anesthesia will be used. It will block pain and keep you asleep during the surgery.

Description of the Procedure

This may be done as an open surgery or using an endovascular approach.

For the endovascular repair, a small incision will be made in your leg. A sleeve will be inserted in this incision and into the aorta. It will be advanced to the aneurysm. The sleeve will take pressure off the wall and prevent it from expanding or leaking. If you need additional heart surgery, it may be done at this time. The incision will then be closed.

In some cases, open surgery may be needed. An incision will be made in the chest. The ribs will be spread. The weakened area of the aorta will be replaced with a graft. The graft will be sewn into place. Blood will be able to flow through the graft. If you need additional heart surgery, it may be done at this time. The chest incision will then be closed with stitches or staples.

Immediately After Procedure

After the operation, you will be taken to the recovery room. Your heart, blood pressure and other vital signs will be monitored.

How Long Will It Take?

2-4 hours

How Much Will It Hurt?

Anesthesia prevents pain during surgery. You will be given pain medication to help manage pain during recovery.

Average Hospital Stay

The usual length of stay is 7 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

The hospital staff may:

The hospital staff may:

  • Provide you with medication and nutrition through an IV.
  • Ask you to take deep breaths and cough to prevent mucus from collecting in your lungs.
  • Ask you to walk down the hall when you are able.
  • Ask you to drink liquids until you can tolerate more solid foods.
At Home

When you return home, take these steps:

When you return home, take these steps:

  • Avoid smoking.
  • Maintain a healthy weight.
  • Follow a diet that is low in fat and includes fruits, vegetables, and whole grain foods.
  • Participate in a rehabilitation program if advised to do so by your doctor.
  • Be sure to follow your doctor’s instructions.

Call Your Doctor

Call your doctor if any of these occur:

  • Irregular heartbeat
  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
  • Signs of infection, including fever and chills
  • Burning, pain, or problems when urinating
  • Nausea or vomiting
  • Unusual fatigue or depression
  • New, unexplained symptoms
  • Cough, shortness of breath, or chest pain

If you have an emergency, call for emergency medical services right away.

Revision Information

  • National Heart, Lung, and Blood Institute, NIH

    http://www.nhlbi.nih.gov

  • The Society for Vascular Surgery

    http://www.vascularweb.org

  • The Canadian Society for Vascular Surgery

    http://canadianvascular.ca

  • Heart and Stroke Foundation of Canada

    http://www.heartandstroke.com

  • Aortic aneurysm repair. University of Michigan Health System website. Available at: http://www.med.umich.edu/cardiac-surgery/patient/adult/adultcandt/aneurysm%5Frepair.shtml. Accessed February 23, 2016.

  • Healthy heart diet. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/heart/prevention/askdietician/healthydiet.aspx. Accessed March 11, 2015.

  • Repair of a thoracic aortic aneurysm. VascularWeb website. Available at: https://www.vascularweb.org/vascularhealth/Pages/thoracic-aortic-aneurysm.aspx. Accessed April 5, 2016.

  • Thoracic aortic aneurysm. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 16, 2015. Accessed March 15, 2016.

  • Thoracic Aortic Aneurysm Surgery. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/heart/services/aorta-surgery/surgerythoracicaneurysm. Accessed March 11, 2015.

  • Thoracic Aortic Aneurysm Repair. University of Wisconsin-Madison School of Medicine and Public Health website. Available at: http://www.uwhealth.org/heart-cardiovascular/thoracic-aortic-aneurysm-repair-open-surgical/11103. Accessed March 11, 2015.

  • Thoracic aortic aneurysm. VascularWeb website. Available at: https://www.vascularweb.org/vascularhealth/Pages/thoracic-aortic-aneurysm.aspx. Updated December 2010. Accessed March 11, 2015.

  • What is an aneurysm? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/arm. Updated April 1, 2011. Accessed March 11, 2015.