Aortic Surgery- Cardiology

Doctors: Cardiologists, cardiothoracic surgeons

What is aortic surgery?

The aorta provides oxygen-rich blood to the body from the heart. During certain conditions such as hypertension, atherosclerosis, connective tissue disorders etc. aorta can either dilate (become wide) or constrict. Aortic surgery is required when an artery wall in the aorta weakens and the wall unusually enlarges or swells as blood is getting pumped through it. The swelling of the aortic wall is called an aortic aneurysm, and it can lead to aortic dissection. An aneurysm can develop anywhere along the aorta. During aortic dissection, the layers of the wall of the aorta are forced apart through augmented blood flow.

The procedure:

Aortic surgery is performed for most aortic disorders. The patient is given general anesthesia and the surgery may last up to three to six hours. For patients with the conditions related to the ascending part of the thoracic aorta, an incision is made in the front of the chest and the breastbone is opened. For patients with the diseases related to the descending thoracic aorta or thoracic abdominal aorta, the incision is made on the left side of the chest. For patients with the diseases related to the abdominal aorta, the surgeon would make an incision in the abdomen or side.

If an aneurysm involves the descending aorta and the abdominal aorta, bypass machine is not used. During the procedure, the aorta is clamped above and below the aneurysm and then replaced by using well-tolerated synthetic material. If an aneurysm involves the ascending aorta or the aortic arch, a bypass machine is used.

In certain cases, when the surgery involves the blood vessels leading towards the head and upper body, a hypothermic circulatory arrest may be done to cool the patient’s body and stop circulation overall.

After the aorta is exposed, the clamps are placed above and below the diseased part. Next, the surgeon opens the aorta, removes the damaged part, and replaces it with a fabric graft. The clamps are removed and the heart-lung bypass machine is shut down, and permits the blood to circulate in the body. After the procedure is over, the incision is closed and covered with sterile bandages.

What to expect after the surgery?

After the surgery, patient would be recommended to join cardiac rehab program for healthy recovery.

References:

• https://www.uwhealth.org/heart-cardiovascular/aortic-surgery-open-surgical-repair/10978
• https://my.clevelandclinic.org/health/treatments/16884-complex-aorta-surgery
• https://www.webmd.com/heart-disease/what-surgeries-treat-aortic-anuerism#1

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