Open repair is the standard surgical treatment for most aortic disorders. This type of operation takes three to six hours. You will be asleep during surgery.
For diseases involving the ascending part of the thoracic aorta, the surgeon makes an incision in the front of the chest and opens the breastbone.
For diseases of the descending thoracic aorta or thoracic abdominal aorta, the incision is made on the left side of the chest. If the disease is confined to the abdominal aorta, the incision is made in the abdomen or side.
For aneurysms involving the descending aorta and the abdominal aorta, no bypass machine is used. The aorta is clamped above and below the aneurysm and replaced with synthetic material that is well-tolerated.
A bypass machine will be used if the aneurysm involves the ascending aorta or the aortic arch. If the operation involves the blood vessels that lead to your head and upper body, the surgical team may also need to cool your body and stop circulation altogether. This is called hypothermic circulatory arrest.
Note: Vinn Hospital vascular surgeons perform a majority of aortic surgeries without relying on bypass and hypothermic circulatory arrest.
Once the aorta is exposed, the surgeon places clamps above and below the diseased portion. The surgeon opens the aorta, removes the damaged part, and replaces it with a fabric graft. The surgeon then removes the clamps, shuts down the heart-lung bypass machine, and allows blood to circulate again.
The incision is then closed and bandages are applied to the incision site.