The aorta is the main blood vessel that provides blood to the rest of the body. When you get an aneurysm in your aorta, it can enlarge to the point of rupturing. An ascending aortic aneurysm happens very close to the heart, which is a high-risk area. The Aortic Center at UVA has the expertise and experience needed to excel in aneurysm repairs. Cardiac surgeon Kenan Yount, MD, walks us through the causes, treatment options, and recovery process of ascending aortic aneurysm repair.
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Transcript
The aorta is the main blood vessel that comes off the heart. And the very first part thatcomes off the heart above the aortic valve is the aortic root, followed by the ascending aorta. And so that area of the aorta right next to the heart is obviously high-risk territory.
An aneurysm simply means that the aorta is larger than normal. And we know from studies and real-life experience that larger blood vessels are more prone to both rupture or tearing. Tearing, medically, we call a dissection.
We frequently will do surveillance on aneurysms for several years, and try to look at the rate of growth that the aneurysm displays on CT scans. Or we also may instead look at the absolute size criteria of the aorta. And that gives us a good guide as to when to replace the aorta. And we try not to replace it any sooner than we have to, balancing the risk of doing a surgery against the risk of the aneurysm rupturing.
If untreated, an aneurysm can sometimes enlarge to the point where it is likely to rupture or tear. In either of those scenarios, it could be life-threatening if one of them were to happen before we had a chance to replace the aorta.
Ascending aortic repair is probably one of the largest procedures a patient could have, and it can be very complex, depending on the extent of the aneurysm. Over the years, we've made a number of advances in how we both protect the heart and the brain during these surgeries. UVA is really at the forefront and leading the advances of both cardiac protection and cerebral perfusion.
Ascending aortic repair can take anywhere from four to five hours. Patients frequently go to an intensive care unit for the first night or two after their operation where they're closely monitored, and then they can recover for about another three days on a regular ward bed. Overall, recovery can take anywhere at home from four to six weeks. And usually we try to start cardiac rehab at the six-week mark to get patients back on their feet and going again.
Given both the risk of stroke and the risk of cardiac damage during these procedures, UVA is ideally suited to providing both surgeries, be it open surgery or interventions which are more minimally invasive. We have a fair amount of expertise collected over the past 20 to 30 years that have allowed us to do this in a much safer fashion than the surgeries used to be done.
