Aortic repair surgery

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At Aurora St. Luke’s Medical Center, we’re here to help treat aorta problems. We offer rapid treatment for aortic emergencies and ongoing observation if you have known aneurysms. We also offer cutting-edge treatments available such as hybrid technologies and minimally invasive approaches, providing you with the highest quality patient-centered care available.

Fighting a common disease with an uncommon treatment

Eric Weiss, MD, is among the cardiac surgeons at Aurora St. Luke’s Medical Center who specializes in surgeries of the aorta. In this video, Dr. Weiss discusses the treatment options available to help repair your aorta so you can get back to being you.

What is an aorta?

The aorta is the major blood vessel that takes blood away from the heart. Your aorta is about a foot long and extends from your heart down through the center of your body.

Aortic aneurysm, a common condition affecting the aorta, occurs when a wall of the aorta weakens and the vessel balloons out. If it’s not repaired, the weakened area can eventually rupture, causing life-threatening internal bleeding. Your doctor will determine how to repair an aortic aneurysm based on its size, location and other contributing medical conditions.

Aortic tears, another condition affecting the aorta, occurs when layers of the aorta tear or separate from each other. This can cause internal bleeding.

Aorta treatments

You’ll most likely need aortic aneurysm open heart surgery to repair aorta problems.

During the surgery, the abnormal portion of the aorta is removed and replaced with a man-made grafting material. Your surgeon also might replace the aortic valve depending on where the aneurysm is located.

Another option is an endovascular repair. Depending on the size and location of your aneurysm and other health conditions, your repair may be done by having a catheter put into an artery in your groin where it can be used to guide a stent into your aorta.

Prior to aorta repair surgery, your doctor may request tests including:

  • Cardiac catheterization: Checks for blockages in the blood vessels of the heart
  • Carotid ultrasound: Checks the arteries in your neck for blockages, which could potentially interfere with blood flow to the brain and increase your stroke risk
  • Chest X-rays
  • Dental examination
  • Echocardiogram: Checks your heart muscle strength and the function of your heart valves
  • Electrocardiograph testing (EKG): Checks your heart rate and rhythm
  • Lab testing: Checks your kidney function, liver function, blood count, urine, thyroid function and blood type in case a transfusion is needed during your surgery

On the day before your aorta repair surgery, you’ll be asked to wash your chest and legs using a special soap to help prevent infection by killing bacteria.

You'll also hear from your surgery team about personalized guidelines to prepare for surgery including:

  • Refraining from eating or drinking anything after midnight the night before your procedure
  • Giving instructions on how to get ready for your procedure including any medications you may need to stop taking
  • Answering your questions and concerns

You’ll arrive at the hospital two hours prior to your aortic repair surgery. Before surgery, you’ll receive a general anesthetic that will put you to sleep so you won’t feel any pain. You’ll also receive a breathing tube and a bladder catheter.

Minimally-invasive surgery

You’ll arrive at the hospital two hours prior to your minimally invasive aorta repair procedure. Before the procedure, you’ll receive general anesthesia and possibly a breathing tube.

Minimally invasive procedures typically take one to two hours. During the procedure, your surgeon will make a small two-inch incision, typically in the ribs. Unlike traditional open heart surgery, you will not need a heart-lung bypass machine. Your heart will be beating on its own throughout the procedure.

During surgery, your surgeon and interventional cardiologist repair the aorta. Once the procedure is complete, your surgeon will close up the incision. We'll make sure the new valve is working correctly by performing a follow-up echocardiogram.

Traditional surgery

An aortic repair surgery typically takes three to five hours. During the procedure, your surgeon will make an incision down the middle of your breastbone, about seven inches long. You’ll be connected to a heart-lung bypass machine, which allows your surgeon to stop your heart from beating and move the blood away from your heart.

During aortic aneurysm open heart surgery, you’ll receive a drainage tube in your chest cavity to drain blood and fluid. You’ll also get temporary pacemaker wires in case your heart rate becomes too slow or requires assistance with rhythm.

Once surgery is complete, your surgeon will put your breastbone back together with metal wires and close the skin with sutures and, in some cases, staples.

You’ll spend the first one or two days in an intensive care unit. You'll be transferred to a regular room once your heart rhythm and blood pressure stabilizes and you no longer need intravenous medications. Most likely you’ll stay in the hospital for four to six days after surgery.

We’ll remove the chest drainage tubes and temporary pacing wires in the days after aorta repair surgery once it's deemed safe. During your stay, you’ll work with cardiac rehabilitation, and possibly physical and occupational therapists to increase your strength and mobility.

Typically, you’ll be able to go home once you:

  • Have a stable blood pressure, heart rate and rhythm
  • Can walk safely
  • Have adequate pain control
  • No longer need oxygen

You may require short- or long-term medication depending on whether you had aortic valve repair or replacement. As your pain improves, you'll transition from intravenous pain medication to pain pills.

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