How is a Thoracic Aortic Aneurysm Treated?

Treatment for a thoracic aneurysm depends on its size, location and your overall health. Together with your doctor, you will decide on the best option for treating your thoracic aneurysm. If your doctor feels the aneurysm is at risk to burst or rupture, the treatment is open surgery, but a newer, less invasive treatment may now be available to you.

Conventional Open Surgery

In conventional or open surgery, the surgeon reaches the aneurysm through an incision in the chest. The weakened section of the vessel, where the aneurysm has formed, is usually surgically removed and replaced with a synthetic material.  Open surgery is usually performed under general anesthesia and takes about three or four hours to complete. Repairing the aneurysm surgically is complex and requires an experienced thoracic surgical team. After your surgery, you would normally stay in the Intensive Care Unit at least a day or two, and then another five to seven days in the hospital, depending on how your body heals.  Your recovery time may be about 3 to 6 months before you feel able to resume your normal activities.

Endovascular Thoracic Stent-Grafting

In recent years, an alternate treatment known as Endovascular Thoracic Stent-Grafting has been developed.  It is used widely in Europe and recently the US with much success.  By avoiding major surgery, this less invasive procedure results in less blood loss and fewer days of hospitalization.

Thoracic Stent Grafting

In this procedure, the Thoracic Stent-Graft, which is a woven fabric tube supported by a tubular metal scaffold, is placed inside the diseased aorta without a major surgical incision. It seals off the aneurysm by fitting inside the diseased part of the aorta, making a new path for blood to flow.

The procedure begins with the Thoracic Stent-Graft usually being inserted through small incisions in the groin.  Catheters are used to guide and deliver a stent-graft through the blood vessels to the site of the aneurysm. The Stent-Graft is then positioned in the diseased part of the aorta to isolate it and divert blood flow away from the aneurysm.

The Thoracic Stent grafting surgery can be done under general, regional or local anesthesia and typically takes 1 to 3 hours to complete.  Your hospital stay may only last a few days, and you should be back to your normal activities within 2-6 weeks after the procedure. Of course, you’ll need to follow up regularly with your medical provider, so they may evaluate the success of your treatment over time.

What Should I Expect After The Procedure?

Immediately after the procedure, your doctor may ask you to lay flat for several hours, allowing the healing process to begin. Once you start getting up and around, any pain or swelling you experience should begin to decrease and you should be released from the hospital within a few days.

Your doctor will discuss your follow-up plan, which will probably include check-ups at one month, six months, twelve months, and annually thereafter.

As with all patients dealing with heart disease, its recommended you follow a heart healthy diet, similar to the one suggested by the American Heart Association.