Aortic Aneurysm Repair
What is an aortic aneurysm?
An aortic aneurysm is an abnormal enlargement of the large blood vessel (about the size 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
Often abdominal aortic aneurysms are found before symptoms, such as back pain or constant pain in the abdomen, progress. 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:
- High blood pressure
- High cholesterol
Screening for Abdominal Aortic Aneurysms
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:
- CT scan
- MRI (magnetic resonance imaging)
Treating Abdominal Aortic Aneurysms at Norwalk Hospital
Norwalk Hospital’s Phyllis and David Komansky Cardiac and Vascular Center has an experienced multidisciplinary team, including vascular surgeons and radiologists, with vast expertise in the treatment of abdominal aortic aneurysms.
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 and may ask to you have an ultrasound test every six months to a year to monitor the growth of the aneurysm.
Large aneurysms may require surgery. If surgery is necessary, Norwalk Hospital offers the following options:
Open surgical repair: During an open abdominal aortic aneurysm repair, the damaged section of aorta is removed and replaced with a stent graft through an incision in the abdominal wall. Full recovery may take one to two months.
Endovascular repair: Endovascular aneurysm repair (EVAR) is a less invasive surgical procedure that involves inserting an endovascular stent graft through a catheter placed in the femoral artery in the groin. The endovascular graft is expanded inside the aorta and reinforces the area needing repair. Recovery from EVAR typically takes about one week.
Advantages of EVAR over traditional open surgery include:
- It is performed through two small incisions, each measuring less than 1/3 of an inch.
- The procedure is faster and less dangerous, with a lower risk of post-operative complications.
- There is a quicker recovery and a shorter hospital stay.
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 or aneurysms not fixable by traditional stent grafts. FEVAR is considered the next major advancement in complex aortic aneurysm management. This procedure is performed at Danbury Hospital.
The stents used in FEVAR are custom molded to fit each individual's aorta based on a 3D computer model rendered 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.