Ascending and Descending Thoracic Aorta Surgery
Background
The arch's downward portion, called the descending aorta, is connected to a network of arteries that supplies most of the body with oxygen-rich blood. The upward part of the arch, which is the section closest to the heart, is called the ascending aorta. The part of the aorta in the chest is called the thoracic aorta.
Ascending or descending aortic replacement are performed when there is an aneurysm enlargement (dilation) or dissection (tear) of the aorta. The ascending aorta can also sometimes include the root (where the heart meets the aorta) and can affect the valve. When the valve is also affected, an aortic root replacement is required (see aortic root replacement).
The conditions that can lead to aortic aneurysm or dissection include atherosclerosis (fat and calcium buildup in the arteries), hypertension (high blood pressure), genetic conditions (such as Marfan's Syndrome), connective tissue disorders (such as Ehler-Danlos disorder, scleroderma) and direct trauma.
Ascending Aorta - the weak aortic wall is replaced with a graft.
About the surgery
First, the heart and aorta are accessed by dividing the sternum (breastbone). During the operation, a device called a heart-lung machine will do the work of your heart. A cold solution will stop your heart so the surgeons can work on a still heart.
Your surgeon will remove the bulging weak area and sew a man-made substitute, called a graft, into place.
After your surgeon does all of the repairs, normal blood flow through your heart and your aorta will resume. Your surgeon will then close the incision in your chest. You may have temporary pacemaker wires coming from the skin as well as drainage tubes to drain blood.
Recovery period
Patients usually stay in the intensive care unit for two to three days for monitoring, and then moved to the ward for four to five days. Two to three tubes stay in the chest to drain fluid from around the heart and are usually removed one to three days after the surgery. Full recovery usually takes about two months. Your surgeon will provide specific guidelines for your recovery and return to work.
Risks of the surgery
As with all surgery, aortic arch surgery is associated with some risks. Your surgeon will calculate these risks specific to you, and discuss them with you.
All patients should consult their cardiothoracic surgeon for specific information about their medical condition and surgery.