Aortic aneurysm surgery
Aortic aneurysm surgery is a procedure used when an aneurysm is causing symptoms, has reached a certain size or is increasing in size over a short period of time. There are two primary types of aortic aneurysm surgery.
- Thoracic aortic aneurysm open repair: The type of surgical repair of a thoracic aortic aneurysm will depend on several factors: the location of the aneurysm, the type of aneurysm, and the patient's tolerance for the procedure. For an ascending or aortic arch aneurysm, a large incision may be made through the breastbone (median sternotomy). If an ascending aneurysm involves damage to the aortic valve of the heart, the valve may be repaired or replaced during the procedure. For a descending aneurysm, a large incision may extend from the back under the shoulder blade around the side of the rib cage to just under the breast (thoracotomy). These approaches allow the surgeon to visualize the aorta directly to repair the aneurysm.
- Endovascular aneurysm repair (EVAR): EVAR is a procedure which requires only small incisions in the groin, along with the use of x-ray guidance and specially-designed instruments, to repair the aneurysm by inserting a tube, called a stent-graft, inside the aorta. Not all thoracic aneurysms can be repaired by means of EVAR
A small aneurysm or one that doesn't cause symptoms may not require surgical treatment until it reaches a certain size or is rapidly increasing in size over a short period of time. Your doctor may recommend "watchful waiting." This may include a CT scan or MRI scan every six months to closely monitor the aneurysm, and blood pressure medication may be used to control high blood pressure.