Surgical Associates of Texas, P.A. - Surgical Procedures
 

Aneurysms

 X-ray of an aneurysm of the ascending aorta.Aneurysms result from weakening of the wall of an artery and could be fatal

An aneurysm is a balloon-like bulge in the wall of a weak or damaged artery. The pressure of blood passing through this weakened part of a blood vessel can force it to bulge outward. Although aneurysms can form in any artery in the body, most occur in the brain or aorta (ascending and descending thoracic aorta and abdominal aorta). The illustration at right shows an X-ray of an aneurysm of the ascending aorta. The rupture of an aneurysm can be fatal. Additionally, other problems associated with aneurysms can be dangerous, such as clot formation that can block the blood flow to a vital organ.

Aneurysm causes

Any condition that causes the arterial walls to deteriorate can lead to an aneurysm. Atherosclerosis (the natural process that occurs throughout the body and results in the hardening and narrowing of the arteries), high blood pressure, and smoking are risk factors. As the inside walls of an artery form plaque, it becomes narrower and the flow of blood through the artery becomes slower. The increased blood pressure that results can weaken the artery wall and cause it to swell out like a balloon.

Ascending Aorta Thoracic Aneurysms

Ascending Aortic Thoracic Aneurysms.This type of aneurysm occurs in the part of the aorta that passes up through the chest (thoracic) area, sometimes including the arch. Ascending aortic thoracic aneurysms (AATA) may involve the aortic valve and the major arteries to the head and arms. This type of aneurysm is illustrated at right. An occlusion of one of the arteries branching off the aorta is also shown (in yellow). 

Ascending Aorta Thoracic Aneurysm Symptoms

Symptoms vary depending on the type and location of the aneurysm, and result from pressure caused by the aneurysm pressing against organs, nerves, and other blood vessels. These may include:

  • Shortness of breath
  • Hoarseness
  • Dry cough
  • Pulsating pain in the chest or head

Ascending Aortic Thoracic Aneurysms After Surgical Repair with Dacron Tube GraftSurgical Treatment of Ascending Aorta Thoracic Aneurysms

Aneurysms in the ascending aorta are usually operated on immediately. AATA surgery involves the surgeon locating the aneurysm, clamping the artery to control bleeding, and removing the enlarged section of the aorta and replacing it with a Dacron tube graft. If the aneurysm is affecting the aortic valve, the valve will also be replaced. Use of the heart-lung machine is required for this type of surgery. Following the operation, a stay in the intensive care unit (ICU) is usually required, followed by another five to seven days in the hospital. At right we show the repair of the aneurysm illustrated above.

Aneurysms of the Descending Thoracic Aorta

Aneurysms of this type involve the section of the aorta in the chest (thoracic) area from the subclavian artery leading to the left arm to the abdomen.

Descending Aorta Thoracic Aneurysm Symptoms

Symptoms vary depending on the type and location of the aneurysm, and result from the pressure caused by the aneurysm pressing against organs, nerves, and other blood vessels. These may include:

  • Pain under the left shoulder or chest wall
  • Pain may occur between shoulder blades

Descending Aorta Thoracic Aneurysm Surgical Treatment

Aneurysms of the descending thoracic aorta (ADTA) may be monitored for growth. If they continue to grow or become symptomatic, surgical intervention is generally indicated. The surgery usually takes three to four hours and sometimes requires use of the heart-lung machine. Following the incision in the left chest under the arm, the surgeon will remove the diseased section of the aorta and replace it with a Dacron tube graft. A stay in the intensive care unit (ICU) is usually required for this surgery, followed by another five to seven days in the hospital.

 Abdominal Aortic Aneurysms

Abdominal aortic aneurysms (AAA) occur in the section of the aorta that passes through the abdomen.

Abdominal Aortic Aneurysm Symptoms

Symptoms vary depending on the type and location of the aneurysm, and result from the pressure caused by the aneurysm pressing against organs, nerves, and other blood vessels. These may include:

  • Back pain
  • Abdominal pain
  • Loss of appetite
  • Nausea

Abdominal Aortic Aneurysm Post Surgical Repair With Dacron Tube GraftSurgical Treatment of Abdominal Aortic Aneurysms

Surgery for Abdominal Aortic Aneurysms takes two to three hours to complete. Once the surgeon locates the aneurysm and clamps the artery to control bleeding, he will remove this enlarged section of the aorta, and replace it with a Dacron graft. If the aneurysm is in the lower part of the abdomen, it may involve the part of the aorta that divides into the femoral arteries. In this situation, the surgeon may use a bifurcated (divided) graft in order to ensure adequate blood flow to the legs. Typically, the patient will spend one night in the ICU and another five to six days in the hospital prior to discharge. At right we show a typical repair of the abdominal aorta in the region of the kidneys. Note that the graft includes portions of the left and right common iliac arteries.

Left Ventricular Aneurysms

Sometimes after a heart attack the damaged wall of the left ventricle, the heart's main pumping chamber, becomes scarred and grows thinner and weaker, significantly reducing the heart's pumping ability. This condition is called a ventricular aneurysm. Ventricular aneurysms may cause shortness of breath, chest pain, or arrhythmia. Ventricular aneurysms need to be surgically repaired if they result in congestive heart failure, left ventricular heart failure, or arrhythmia.

Surgical Associates of Texas, P.A., the cardiovascular surgical team at the Texas Heart Institute, have more experience than any other cardiovascular surgical group in the world, having performed approximately 100,000 open heart surgeries of all types and degrees of complexity and over 800 heart transplants. Many of our patients have had successful operations and recovery when previously led to believe that no further treatment options were possible.


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Last revised April 2005