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Repair of a Thoracic Aortic Aneurysm 

A thoracic aortic aneurysm repair is done to prevent rupture and escape of blood into the chest cavity. 

When an aneurysm occurs in a portion of the aorta within your chest, it is called a thoracic aortic aneurysm (TAA). In order to predict the risk of rupture, the TAA diameter is measured using a computed tomography (CT) scan. Surgery is typically recommended for patients with a thoracic aortic aneurysm about 5.5cm (2 inches) and larger.  

The two most common surgery options for thoracic aortic aneurysm are: 

  • Open chest surgery, which involves removing the damaged section of the aorta and replacing it with a synthetic graft (tube), which is sewn into place.  
  • Endovascular surgery in which doctors cover the aneurysm with a stent graft that's inserted through an artery in the leg and threaded up into the aorta.  

Your doctor will determine the type of surgery you should have depending on your condition and the location of your thoracic aortic aneurysm. 

Conditions Treated 

Thoracic aortic aneurysms need to be treated with surgery if they are larger in size and have a higher chance of rupturing. If a thoracic aortic aneurysm ruptures, it is a medical emergency.  

Procedure Details 

Most people with a thoracic aortic aneurysm have open-chest surgery. During this procedure, the patient is put under general anesthesia, an incision is made and the ribs are spread. The weakened area of the aorta is replaced with an artificial blood vessel (graft) made of cloth and sewn into place. Blood flow through the aorta must be stopped temporarily and blood circulation to the body is maintained using mechanical pumps while the aorta is clamped. 

With endovascular thoracic aortic aneurysm surgery, doctors attach a synthetic graft to the end of a thin tube that's inserted through an artery in your leg and threaded up into your aorta. Small hooks or pins keep the graft in place as it reinforces the weakened section of the aorta, preventing the aneurysm from rupturing.  

What to Expect 

Repairing a thoracic aortic aneurysm is a major surgical procedure and therefore presents a number of potential risks. These can include:  

  • Bleeding 
  • Respiratory complications such as pneumonia 
  • Temporary or permanent loss of kidney function 
  • Interruption of blood flow to the spinal cord 

Effectiveness 

It is important to repair aneurysms before they rupture, because once a thoracic aneurysm ruptures chances of survival fall to 50%. But when patients receive thoracic aortic aneurysm repairs, chances of survival are greater than 90%. It’s also crucial for the repair of thoracic aortic aneurysms to be performed by highly experienced surgeons, such as the team at Tampa General Hospital’s Heart & Vascular Institute.