Thoracic Aortic Aneurysm Repair

What Is Thoracic Aortic Aneurysm Repair?

The aorta is the largest artery in the body. It begins at the heart and runs through the chest and abdomen. Sometimes the walls of the aorta weaken and bulge in one area. That weakness or bulge is called an aneurysm. An aortic aneurysm repair supports or replaces the weakened area.

Reasons for Procedure

• To prevent an aneurysm from rupturing/bursting, which causes severe, life-threatening bleeding
• To prevent dissection, which is a tear in the innermost layer of the aorta

Description of Procedure

Before you are brought to the operating room (OR), you will have IVs placed and your skin prepped. Once in the OR, a breathing tube will be placed in your throat and you will be given anesthesia until you are fully asleep.

An incision will be made through the skin and the breastbone will be split to open the chest. You will be connected to a heart–lung machine. Since the heart needs to be stopped for the surgery, this machine will temporarily act as your heart and lungs. The diseased part of the aorta is removed and replaced with a graft (tube) through which blood can flow.

Possible Complications

If you are planning to have a thoracic aortic aneurysm repair, your doctor will review a list of possible complications, which may include:

• Bleeding
• Damage to other organs, such as the kidneys
• Infections
• Irregular heart rhythm
• Stroke
• Death

Some factors that may increase the risk of complications with heart surgery include:

• Diabetes
• Kidney disease
• Lung disease, especially chronic obstructive pulmonary disease (COPD) (emphysema)
• Obesity
• Prior heart attack or cardiac surgery
• Smoking

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam
• Chest X-ray
• Lab work
• Echocardiogram
• Electrocardiogram (ECG, EKG)
• Cardiac catheterization

Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as:

• Blood-thinning drugs, such as warfarin (Coumadin)
• Anti-platelet drugs, such as clopidogrel (Plavix)
• Diabetes medications, such as metformin (Glucophage)

Your doctor may also ask you to:

• Eat a light meal the night before. Do not eat or drink anything after midnight.
• Arrange for a ride to and from the hospital
• Arrange for help at home after the procedure

Anesthesia

General anesthesia will be given. You will be asleep during the procedure.

Immediately Afterwards

You will be monitored in the Intensive Care Unit (ICU), where you will have the following interventions:

• Heart monitor
• Pacing wires to control heart rate
• Tubes connected to a machine to drain fluids from the wound
• Breathing tube or an oxygen mask
• Catheter inserted into the bladder

Post-Procedure Care

At the Hospital

• To reduce the risk of fluid buildup in your lungs, you will be instructed to breathe deeply and cough 10 to 20 times every hour.
• Efforts will be made to get you out of bed and walking as soon as possible.
• Dressings will be removed in a day or two. Pacing wires and chest tubes will be removed within the first few days.

Back at Home

When you return home, do the following to help ensure a smooth recovery:

• Take medicines as directed by your doctor, such as:
  
  • Antiarrhythmics
  • Blood thinners
  • Cholesterol-lowering medicine
  • Blood pressure medicine
  • Pain medicine
• Follow your doctor’s guidelines for caring for your incisions
• Weigh yourself every morning
• Be sure to follow all of your doctor’s instructions

Recovering after Surgery: What to Expect

Every patient’s recovery can be different. You will need to shower, daily, with a mild soap. Ask your doctor when it is safe to take a bath or soak in water. You may find that there will be some areas of discomfort in the area of surgery that can last for several weeks. Also, it is common that you may feel tired for many weeks following this type of surgery.

You will be asked not to do any type of heavy lifting for two months that will cause pain at the surgical site. People with jobs requiring strong physical activity may require additional time before resuming those types of activities. Be sure to ask your doctor when you can drive and return to work.

When to Call Your Surgeon

Check in with us as soon as possible if you experience any of these serious symptoms:

• Pain that you cannot control with the medication you have been given
• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision sites
• Nausea and/or vomiting that you cannot control with the medication you were given after surgery or that lasts longer than expected
• Cough, shortness of breath, or chest pain
• Pain, burning, urgency, frequency of urination, or persistent blood in the urine
• Gaining more than four pounds within one or two days
• Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain

In case of an emergency, call for medical help right away.

Frequently Asked Questions

How long will it take?

The surgery can take anywhere from 3 to 5 hours.

How much will it hurt?

Anesthesia prevents pain during surgery. You may be given medication for any pain during recovery. Pain levels vary from patient to patient.

What is the average hospital stay?

The average stay is 4 to 7 days.

Meet with a Doctor within One Week

To learn more about how we can help you, contact us. We’ll return your call the same day and can secure you an appointment with one of our doctors within the week.

Call 617.789.2045 to request an appointment.

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