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Aortic Aneurysm Repair at Norwalk Hospital

If you are diagnosed with an aortic aneurysm, it’s important to know that you have access to expert treatment at Norwalk Hospital’s Phyllis and David Komansky Cardiac and Vascular Center. Our experienced multidisciplinary team, which includes vascular surgeons and radiologists, has vast expertise in treating aortic aneurysms with excellent results. 

An aortic aneurysm is an abnormal enlargement of the aorta, the large blood vessel (about the diameter of a garden hose) that carries blood from the lower part of your heart through the chest and into the abdomen.

The majority of aortic aneurysms occur in the part of the aorta located in the abdomen and are called abdominal aortic aneurysms (AAA or “triple A”). Aortic aneurysms that occur in the chest are called thoracic aortic aneurysms. Thoracic aortic aneurysms are far less common than abdominal aortic aneurysms.

Abdominal aortic aneurysms are often found before symptoms, such as back or abdominal pain, occur. Some abdominal aortic aneurysms will never cause a problem. A ruptured aneurysm, however, may cause life-threatening bleeding. As a result, accurate screening, diagnosis and treatment of abdominal aortic aneurysms is critical.

Risk factors for abdominal aortic aneurysms include:

  • Heredity
  • Smoking
  • High blood pressure
  • Injury
  • High cholesterol 

Many abdominal aortic aneurysms are discovered by a physician during a routine physical examination. Once your physician suspects an aneurysm, the following tests may be used to assess the size and location of the aneurysm:

  • Ultrasound
  • CT scan
  • MRI (magnetic resonance imaging) 

After determining the size of your aneurysm, your surgeon will discuss options for treatment.

Small- to medium-size aneurysms typically require observation, but not surgery. Your surgeon may recommend that you take a medicine used to treat high blood pressure (to reduce the pressure on the aneurysm) and ask to you have an ultrasound test every six months to 12 months to monitor the growth of the aneurysm.

Large aneurysms may require surgery. If surgery is necessary, Norwalk Hospital offers these options:

  • Open surgical repair: During an open AAA repair, the damaged section of aorta is removed and replaced with a stent graft through an incision in the abdominal wall. A stent graft is a mesh-like tubular structure made of metal and a special fabric. Full recovery may take one to two months.
  • Endovascular repair: Endovascular aneurysm repair (EVAR) is a less invasive surgical procedure (performed through two tiny incisions) that involves inserting a stent graft through a catheter advanced through the femoral artery in the groin to the aorta. The endovascular graft is expanded inside the aorta and reinforces the area needing repair. Recovery from EVAR typically takes about one week. It is faster than open surgery, with a lower risk of postoperative complications.
  • Fenestrated endovascular aortic aneurysm repair (FEVAR): FEVAR is a minimally invasive surgical alternative to open aortic aneurysm repair for patients with juxtarenal abdominal aortic aneurysms (aneurysms that extend to the lower part of the kidney arteries) or aneurysms that can’t be fixed with traditional stent grafts. FEVAR is considered the next major advancement in complex aortic aneurysm management.

The stents used in FEVAR are custom molded to fit each patient's aorta based on a 3D computer model produced from a CT scan. Each stent is surrounded with a fabric liner to seal off the aneurysm, in essence forming a new aorta inside diseased arteries. FEVAR makes endovascular repair a possibility for patients who previously had no other option than open surgical repair.