In recent years, new devices were created which allow surgeons to repair thoracic aneurysms via an endovascular approach. In fact, CVTSA surgeons have one of the largest experiences with this surgery on the east coast.
The aorta is the largest artery in the body and is responsible for delivering oxygenated blood to the entire body. Extending upward from the top of the heart's left ventrical into the chest, the aorta then curves like a candy cane and comes down to the lower abdomen. Throughout its length, there are branches which feed blood to various parts of the body. When an abnormal widening or ballooning of the aortic wall occurs near the heart or lungs it is called a thoracic aortic aneurysm. When it occurs in the abdomen, it is called an abdominal aortic aneurysm.
When an aneurysm reaches 5 cm or more, or when a person is experiencing symptoms, it is important to occlude the aneurysm too prevent rupture. Ruptured aneurysms are usually fatal. If an aneurysm is diagnosed and surgically treated, fatal complications may be averted and the patients may expect a normal life span.
The symptoms of a thoracic aortic aneurysm can be similar to other conditions and may include:
pain in the chest, neck, and/or back swelling of head, neck, and arms heart failure wheezing, coughing, or shortness of breath coughing up blood hoarseness difficulty swallowing
To determine if you have a thoracic aortic aneurysm, your physician will conduct a complete medical history and physical examination and order one or all of the following diagnostic procedures: CT scan, MRI, echocardiogram, transesophageal echocardiogram (TEE), chest x-ray or arteriogram or angiogram.
Asymptomatic aneurysms may not require surgical intervention until they reach a certain size or are noted to be increasing in size over a certain period of time. However, for symptomatic aneurysms, immediate intervention is indicated.
The standard treatment was an operation performed through a large incision in the breastbone or the side and was among the most invasive surgical procedures performed in cardiac surgery. These operations also had significant risks of death, stroke, weakness of the legs, bleeding and kidney failure.
New technology has allowed many people to be candidates for endovascular aneurysm repair (EVAR), a procedure which requires only small incisions in the groin and uses x-ray guidance and specially-designed instruments to achieve thoracic aneurysm repair by inserting a tube, called a stent-graft, inside the aorta. This endograft prevents the blood from being in contact with the aneurysm, thus relieving the pressure exerted onto the aneurysm. The graft remains permanently inside of the aorta, held in place by a metal stent that seals against the wall of the aorta.
In a nationally conducted trial of the endovascular stent grafts (Pivotal Trial for the GORE TAG Thoracic Endoprosthesis) there were advantages demonstrated to the minimally invasive procedure vs. the open surgical repair. The results showed decreased weakness in the legs, decreased mortality, less procedural blood loss on average, shortened intensive care and overall hospital length of stay and earlier return to work as compared to open surgical repair.
The aorta is the largest artery in the body and is responsible for delivering oxygenated blood to the entire body. Extending upward from the top of the heart's left ventrical into the chest, the aorta then curves like a candy cane and comes down to the lower abdomen. Throughout its length, there are branches which feed blood to various parts of the body. When an abnormal widening or ballooning of the aortic wall occurs near the heart or lungs it is called a thoracic aortic aneurysm. When it occurs in the abdomen, it is called an abdominal aortic aneurysm.
When an aneurysm reaches 5 cm or more, or when a person is experiencing symptoms, it is important to occlude the aneurysm too prevent rupture. Ruptured aneurysms are usually fatal. If an aneurysm is diagnosed and surgically treated, fatal complications may be averted and the patients may expect a normal life span.
The symptoms of a thoracic aortic aneurysm can be similar to other conditions and may include:
pain in the chest, neck, and/or back swelling of head, neck, and arms heart failure wheezing, coughing, or shortness of breath coughing up blood hoarseness difficulty swallowing
To determine if you have a thoracic aortic aneurysm, your physician will conduct a complete medical history and physical examination and order one or all of the following diagnostic procedures: CT scan, MRI, echocardiogram, transesophageal echocardiogram (TEE), chest x-ray or arteriogram or angiogram.
Asymptomatic aneurysms may not require surgical intervention until they reach a certain size or are noted to be increasing in size over a certain period of time. However, for symptomatic aneurysms, immediate intervention is indicated.
The standard treatment was an operation performed through a large incision in the breastbone or the side and was among the most invasive surgical procedures performed in cardiac surgery. These operations also had significant risks of death, stroke, weakness of the legs, bleeding and kidney failure.
New technology has allowed many people to be candidates for endovascular aneurysm repair (EVAR), a procedure which requires only small incisions in the groin and uses x-ray guidance and specially-designed instruments to achieve thoracic aneurysm repair by inserting a tube, called a stent-graft, inside the aorta. This endograft prevents the blood from being in contact with the aneurysm, thus relieving the pressure exerted onto the aneurysm. The graft remains permanently inside of the aorta, held in place by a metal stent that seals against the wall of the aorta.
In a nationally conducted trial of the endovascular stent grafts (Pivotal Trial for the GORE TAG Thoracic Endoprosthesis) there were advantages demonstrated to the minimally invasive procedure vs. the open surgical repair. The results showed decreased weakness in the legs, decreased mortality, less procedural blood loss on average, shortened intensive care and overall hospital length of stay and earlier return to work as compared to open surgical repair.
About the Author:
In Virginia finding the right doctor for Thoracic Aortic Aneurysms or a virginia thoracic surgeon is crucial.
