Aortic Repair Surgery
Treating Cardiovascular Diseases in Wisconsin and Northern Illinois
The aorta is the major blood vessel that takes blood away from the heart. Repairing disorders of the aorta often require open-heart surgery.
The most common conditions affecting the aorta include:
- Aortic aneurysms, which occurs when a wall of this large artery becomes weak and the vessel balloons out. If not repaired, this weakened area can eventually rupture, causing life-threatening internal bleeding
- Aortic tears, also known as an aortic dissection, which occur when layers of the aorta tear or separate from each other, causing internal bleeding
The decision to repair an aortic aneurysm is based on the size of the aneurysm, its location and other contributing medical conditions.
Aortic repair surgery is performed through an incision in your breastbone. The abnormal portion of the aorta is removed and replaced with a synthetic grafting material. In some cases, the aortic aneurysm can be repaired using a thoracic endovascular stent graft to restore the shape and strength of the aorta.
Depending on the location of the aneurysm, the aortic valve may need to be replaced. Learn more about heart valve repair and replacement.
Surgery to repair the tear and restore blood flow is similar to aortic aneurysm surgery.
Based on the size and location of your aneurysm and other health conditions, you may be a candidate for an endovascular repair of your aortic aneurysm. This is done with a catheter (long tube) that is put into the groin and feeds a stent into the aorta. This stent graft is placed to give a new and more stable lining to the aorta and reinforces the weakened wall of the aorta. This technique can be discussed with your surgeon to see if you are a candidate for this procedure.
Preparing for Aortic Repair Surgery
In the days or weeks before your aortic repair surgery, your doctor is likely to request the following pre-operative tests:
- Cardiac catheterization to check for blockages in the blood vessels of the heart (if not recently done)
- Carotid ultrasound to check the arteries in your neckf or blockages, which could potentially interfere with blood flow to the brain and increase your stroke risk
- Chest X-rays to help identify lung/heart abnormalities before your surgery
- Dental examination if you haven’t had one recently
- Echocardiogram (cardiac ultrasound testing) to check your heart muscle strength and the function of your heart valves
- Electrocardiograph testing (EKG) to check your heart rate and rhythm
- Lab testing to check your kidney function, liver function, blood count, urine, thyroid function and blood type (in case a transfusion is needed during your surgery)
On the day before your aortic repair surgery:
- You will be asked to wash your chest and legs using a special soap that helps kill bacteria to prevent infection. You may also be instructed to clip your chest and/or leg hair.
- You will be given instructions on which medications to STOP taking and which medications you can take the morning of surgery. Important medications to check prior to taking are medications for diabetes, blood thinners, medications that make you urinate more frequently and blood pressure medications.
On the morning of your aortic repair surgery, you will be asked to:
- Arrive at the hospital as directed, usually about 2 hours before your scheduled surgery
- Bring all your medications with you to ensure that your home medication list is correct
- Have your blood pressure and vital signs checked when you are admitted
- Refrain from eating or drinking after midnight
- Take only those medications your doctor has allowed with only a sip of water
Immediately before your aortic repair surgery:
When you are ready for surgery, you will be taken to the pre-op holding area where you will meet the anesthesiologist. As you wait, a nurse will be available to answer any questions.
You will have an IV placed in your arm that will deliver antibiotics. The anesthesiologist will give you medicine to help you relax and make you sleepy.
You may feel cold when you are moved to the operating room and will receive extra blankets to keep warm. You will be transferred to a hard table and, once in position, will receive anesthesia and be prepared for surgery.
During Your Aortic Surgery
Once anesthesia is given, you will be completely asleep. Your anesthesiologist will put in a central line, which is a large IV for delivering medications. Another line will be used to monitor your heart function.
To help with breathing during the surgery, you will have a breathing tube that is connected to a ventilator (breathing machine). You will also have a bladder catheter.
In addition to your anesthesiologist and surgeon, you will have surgical assistants, nurses and a physician assistant helping with your procedure. The average surgery takes about 3 – 5 hours, depending on the amount of work that needs to be done.
During your procedure, your surgeon will make an incision down the middle of your breastbone, approximately 7 – 8 inches long. You will be connected to a heart-lung bypass machine, which allows the surgeon to stop your heart from beating and moves the blood away from your heart.
After surgery is complete, your breastbone will be put back together with metal wires. Your skin will be closed with sutures and, in some cases, staples. Drainage tubes will be put in your chest cavity to drain blood and fluid. Also, temporary pacemaker wires will be placed in case your heart rate becomes too slow or requires assistance with rhythm.
Aortic Surgery Risks
All surgeries have potential risks and compliations. Some risks are higher in older adults and people with other health concerns. Your doctor will explain your risks in greater detail. Potential aortic surgery risksinclude:
- Breathing/kidney problems
- Heart arrhythmias (irregular heartbeat)
- Infection (resulting from surgical wounds, pneumonia or a bladder catheter causing a urinary infection)
- Stroke (with possible short- or long-term effects, depending on its severity)
Aortic Surgery Recovery
After your open-heart surgery, you will be taken from the operating room to the intensive care unit (ICU). You will have a breathing tube in place until you wake up from general anesthesia. After surgery, wires and tubes, including your breathing tube, will be removed as your condition stabilizes.
Once your breathing tube is removed, your heart rhythm and blood pressure stablize, and special intravenous medications are no longer needed, you will be moved out of the ICU. Chest drainage tubes and temporary pacing wires are removed in the days after surgery, once it is deemed safe.
You can expect to remain in the hospital 4 – 6 days following surgery. You will begin an exercise program the day after surgery. Blood pressure, oxygen levels, temperature and heart rhythm will be monitored. Medication adjustments will be made while in the hospital.
You will work with cardiac rehab and possibly physical and occupational therapy to increase your strength and mobility. This activity also helps to prevent complications like pneumonia and blood clots. You will be transitioned from intravenous pain medication to pain pills. These will be decreased as your pain improves.
You will be deemed ready to leave the hospital once you have a stable blood pressure, heart rate and rhythm, are able to ambulate safely, have adequate pain control and are weaned from oxygen.
Depending on the whether you had aortic valve repair or replacement, you may require short- or long-term anticoagulation with Coumadin. This will be started after surgery and you will receive instructions prior to discharge.
Other prescriptions, including pain medication, will also be given at discharge.
Nationally Recognized for Aortic Surgeries
Aurora Health Care has extensive experience performing all types of open-heart surgeries. Our teams include a surgeon, anesthesiologist, operating room nurses, surgical techs, physician assistants, nurse practitioners and nurses, who are specially trained and experienced in valve repair and valve replacement surgeries. As experts in all types of valve surgeries, they can provide you with the best options for your individual needs.
You will see members of your team at your doctor’s visit before surgery, during your surgery and hospital stay, and afterward at follow-up visits. This teamwork helps make sure you get the care you need before, during and after your surgery.
Many Aurora surgeons are involved in research and clinical trials to stay on the cutting edge of surgical technology and techniques. To take care of your other medical needs, our surgeons work closely with other specialists, including cardiologists and doctors who specialize in diabetes, lung conditions and other disorders.
Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or heart specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.