Open surgical repair is one of two options to treat aortic aneurysms. For many patients, surgery is the longest-lasting and safest option to treat aortic aneurysms. An aortic aneurysm
is a bulge in the wall of your aorta, the large blood vessel that carries blood from your heart to the rest of your body. Surgery is an option if the aneurysm is 5 to 5.5 centimeters in size, or smaller for certain genetic syndromes.
Aneurysms in the chest are approached as follows: An open heart surgical procedure involves an opening through the breastbone which is fused at the end of the procedure to lessen discomfort. We use the heart-lung machine during the surgery to keep the heart and brain safe. In some case, we can remove a segment of the aorta and replace it with a polyester tube graft. This graft lasts forever and is rarely exposed to infection or further aneurysm formation.
Aneurysms in the descending aorta often can be treated with a stent graft (although an open procedure may be needed). During this surgery, surgeons place the stent graft using a wire that has been entered through a small puncture in the groin. The graft lines the inner surface of the aorta and diverts blood flow around the aneurysm and into the healthy parts of the aorta. Stent grafts can be customized to meet each patient’s needs.
Aneurysms in the abdomen are approached as follows: An incision is made in the abdomen to gain access to the abdominal aorta. The parts above and below the aneurysm are occluded and the aneurysm is removed. The aorta is sewn back together with an intervening polyester tube graft as described above.
Some aneurysms involve both the chest and the abdomen and require a combination of procedures mentioned above.
We typically monitor patients annually after any aortic procedure and more frequently for stent grafts. Ask your surgeon which monitoring method is best for you. These typically involve an ultrasound, cardiac echo, CT scan or MRI.