aortic repairsurgery


The aorta is the major blood vessel that takes blood away from the heart. Repairing a disorder of the aorta often requires open-heart surgery.

Common conditions affecting the aorta include:

  • Aortic aneurysms: A wall of the aorta weakens and the vessel balloons out. If not repaired, this weakened area can eventually rupture, causing life-threatening 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 tears: Layers of the aorta tear or separate from each other, causing internal bleeding.

treatment options

Aortic repair surgery: Most aorta repair is performed through an incision in your breastbone. The abnormal portion of the aorta is removed and replaced with a man-made grafting material. In some cases, the aneurysm can be repaired using a stent graft. Depending on the location of the aneurysm, the aortic valve may need to be replaced. Surgery to repair the tear and restore blood flow is similar to aortic aneurysm surgery.

Endovascular repair: Based on the size and location of your aneurysm and other health conditions, your repair may be done by having a catheter (long tube) put into your groin that feeds a stent into your aorta. You can discuss this technique with your surgeon to see if you’re a candidate.


In the days or weeks before your aortic repair surgery, your doctor may request the following pre-operative tests:

  • Cardiac catheterization: Checks for blockages in the blood vessels of the heart (if not recently done)
  • Carotid ultrasound: Checks the arteries in your neck for blockages, which could potentially interfere with blood flow to the brain and increase your stroke risk
  • Chest X-rays
  • Dental examination 
  • Echocardiogram (cardiac ultrasound testing): Checks your heart muscle strength and the function of your heart valves
  • Electrocardiograph testing (EKG): Checks your heart rate and rhythm
  • Lab testing: Checks your kidney function, liver function, blood count, urine, thyroid function and blood type (in case a transfusion is needed during your surgery)

what to expect

On the day before your aortic repair surgery, you’ll be asked to wash your chest and legs using a special soap that helps kill bacteria to prevent infection. You’ll be given instructions on which medications to stop taking and which medications you can take the morning of surgery. 

You should refrain from eating or drinking after midnight.  

On the morning of your aortic repair surgery you’ll 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. Take only those medications your doctor has allowed with just a sip of water. Your blood pressure and vital signs will be checked when you are admitted. 

Immediately before your aortic repair surgery, you’ll be taken to the pre-op holding area where you’ll meet the anesthesiologist. You’ll 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.

Once anesthesia is given, you’ll be completely asleep. To help with breathing during the surgery, you’ll have a breathing tube that is connected to a ventilator. You’ll also have a bladder catheter.

During your procedure, your surgeon will make an incision down the middle of your breastbone, approximately 7 to 8 inches long. You’ll 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.

The average surgery takes about 3 to 5 hours, depending on the amount of work that needs to be done.

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.


After your open-heart surgery, you’ll be taken from the operating room to the intensive care unit (ICU). Once your heart rhythm and blood pressure stabilize 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 to 6 days following surgery. You’ll 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 you’re still in the hospital.

You’ll work with cardiac rehab and possibly physical and occupational therapists to increase your strength and mobility. You’ll be transitioned from intravenous pain medication to pain pills. These will be decreased as your pain improves.

You can leave the hospital once you have a stable blood pressure, heart rate and rhythm; can walk safely; have adequate pain control and are weaned from oxygen.

Depending on whether you had aortic valve repair or replacement, you may require short- or long-term medication. This will begin after surgery and you will receive instructions prior to discharge. Other prescriptions, including pain medication, will also be given at discharge.

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