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Thoracic Aortic Aneurysm Repair

(Thoracic Aortic Aneurysm Reconstruction)

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

This surgery may be needed if you have an aneurysm of the aorta. An aneurysm is a weakened area of the blood vessel. It can cause the blood vessel to bulge out. A large aneurysm may burst and cause severe bleeding.

Possible Complications

Your doctor will review potential problems, like:
  • Adverse reaction to anesthesia (such as, lightheadedness, low blood pressure, 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, your doctor may ask for:
  • Tests of your lung function
Your doctor may also ask you to:
  • Stop eating or drinking anything after midnight the night before your surgery.
  • Stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Anti-platelet drugs
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

The surgeon will make an incision in your chest. Clamps will be placed on the aorta above and below the aneurysm. The damaged part of the aorta will be removed. A graft will replace the damaged part of the aorta. The graft is a type of man-made tube. It will be stitched into place. Blood will be able to flow through the graft. When the aorta is repaired, the clamps will be removed. Your doctor will look for any leaks.
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?

Two to four hours

How Much Will It Hurt?

Anesthesia prevents pain during surgery. Your doctor will give you pain medicine 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:
  • Follow your doctor’s instructions on cleaning the incision site.
  • Change your bandages once a day.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Ask your doctor when it is safe to resume physical activities.
  • Avoid smoking.
  • Maintain a healthy weight.
  • Follow a diet that is low in fat and includes fruits, vegetables, and whole grain foods.
  • Your doctor may recommend a rehabilitation program.
  • It may take 4 to 6 weeks to recover.
  • 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 medical help right away.

RESOURCES

National Heart, Lung, and Blood Institute, NIH http://www.nhlbi.nih.gov

The Society for Vascular Surgery http://www.vascularweb.org

CANADIAN RESOURCES

The Canadian Society for Vascular Surgery http://canadianvascular.ca

Heart and Stroke Foundation of Canada http://www.heartandstroke.com

References

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 6, 2013.

Aortic aneurysms. The Society of Thoracic Surgeons website. Available at: http://www.sts.org/patient-information/aneurysm-surgery/aortic-aneurysms. Accessed February 6, 2013.

Healthy heart diet. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/heart/prevention/askdietician/healthydiet.aspx. Accessed February 6, 2013.

Surgery for thoracic aortic aneurysm. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/heart/disorders/aorta%5Fmarfan/surgerythoracicaneurysm.aspx

Thoracic Aortic Aneurysm Repair. University of Wisconsin-Madison School of Medicine and Public Health website. http://www.uwhealth.org/heart-cardiovascular/thoracic-aortic-aneurysm-repair-open-surgical/11103. Accessed February 6, 2013.

Thoracic aortic aneurysm. Massachusetts General Hospital website. Available at: http://www.massgeneral.org/conditions/condition.aspx?id=463. Accessed February 6, 2013.

Thoracic aortic aneurysm. VascularWeb website. Available at: https://www.vascularweb.org/vascularhealth/Pages/thoracic-aortic-aneurysm.aspx. Updated December 2010. Accessed February 6, 2013.

Thoracic aortic aneurysm (TAA). Robert Wood Johnson University Hospital website. Available at: http://www.rwjuh.edu/medical%5Fservices/vascular%5Fcenter%5Fthoracic%5Faortic%5Faneurysm.html. Accessed February 6, 2013.

Thoracic aortic aneurysm repair. St. Luke’s University Health Network website. Available at: http://www.slhn.org/en/Conditions-Services/Heart-Vascular/Services-We-Offer/Heart-Surgery/Thoracic-Aortic-Aneurysm-Repair.aspx . Accessed February 20, 2013.

Thoracic aortic aneurysms. St. Luke’s-Roosevelt Division of Cardiology website. Available at: http://www.slrctsurgery.com/Thoracic%20aortic%20aneurysms.htm. Accessed February 6, 2013.

What is an aneurysm? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/arm/ . Accessed February 6, 2013.

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