Open Thoracic Aneurysm Repair
What is thoracic aneurysm of the descending aorta?
An aneurysm refers to a weakened area in the wall of an artery, which forms an abnormal bulge in the blood vessel. Thoracic aortic aneurysm refers to an aneurysm in the aorta (the largest artery that carries blood away from the heart to the different parts of the body) at the thoracic (chest) region.
The aorta is made of the following parts:
- Ascending aorta: first part that moves away from the heart and towards the head
- Aortic arch: middle part which is curved
- Descending aorta: last part that travels down towards the feet
Descending thoracic aortic aneurysm is characterized by an aneurysm in the part of the aorta that travels down the body through the thorax or chest region. Thoracic aneurysm can be treated through open thoracic aneurysm repair.
What are the indications for open thoracic aneurysm repair of the descending aorta?
Thoracic aortic aneurysm repair is indicated based on the size or rate of growth and symptoms of the aortic aneurysm. If the descending thoracic aortic aneurysm is small and asymptomatic, “watchful waiting” is recommended. Your doctor will closely monitor the aneurysm for any changes that may occur. Surgery is recommended for aneurysms
- reaching a size of ≥6.0 cm
- growing at the rate of ≥1 cm per year
- aortic rupture or dissection (tearing of the aortic wall)
Quitting smoking and taking blood pressure medications are found to slow down the rate of enlargement of an aneurysm. If the thoracic aortic aneurysm is large and symptomatic, prompt treatment is required to prevent a rupture from occurring.
How is open thoracic aneurysm repair of the descending aorta performed?
Cardiothoracic surgeons, not general vascular surgeons, usually perform open surgery for a descending thoracic aneurysm. Open surgery involves the replacement of the defective part of the aorta with a fabric graft. For descending thoracic aortic aneurysm surgery, an incision is made below the shoulder blades in the back, extending around the side to just below the breast, to gain access to the aorta. The weakened bulged portion of the aorta is then removed and replaced with a graft made of polyester fabric. The graft is stronger than the weakened aorta, and allows the blood to flow freely through the graft within the aorta, preventing further enlargement and rupture of the aorta.
What can you expect after open thoracic aneurysm repair of the descending aorta?
Following surgery, you will be required to stay in the hospital for one or two weeks or longer depending on the procedure. You will be able to return to your normal activities in several weeks or longer.
Are there any complications of open thoracic aneurysm repair of the descending aorta?
As all surgical procedures, open thoracic aneurysm repair of the descending aorta may be associated with certain complications that may include, but are not limited to:
- Irregular heartbeats
- Heart attack
- Graft infection
- Paralysis due to injury of the spinal cord
- Kidney damage
However, under a skilled surgeon, open thoracic aneurysm repair of the descending aorta can be a successful treatment procedure for aneurysm of the descending aorta.
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