Afraid of Aortic Root Replacement surgery? Let's talk about it simply! (Aortic Root Replacement)

Did the doctor tell you that the main blood vessel that carries blood from your heart to your entire body has become weak and has a bulge at the base? Or did he tell you that you need surgery? It's normal to feel a little scared when you hear something like that. But this is a very important surgery that can save your life. Today, we'll talk about what this Aortic Root Replacement surgery is, how it's done, and everything you need to know about it.

Simply put, what is Aortic Root Replacement?

The largest and most important blood vessel in the body, the aorta, is connected to our heart. The first part of this aorta where it connects to the heart is called the aortic root. Sometimes the wall of this part becomes weak and starts to bulge like a balloon. This is called an aneurysm.

So, `Aortic Root Replacement` surgery involves removing the weakened and swollen root of the aorta and replacing it with an artificial channel (graft). This can prevent the dangerous conditions I mentioned and save your life.

What are the main types of this surgery?

There are two main methods for performing this surgery. Your doctor will choose the method that is best for you based on your condition.

Subparts of VSRR surgery

VSRR surgery is further divided into two methods: the Yacoub and David methods.

• Yacoub procedure: This involves remodeling the aortic valve. This is more suitable for older people who have developed an aneurysm due to non-genetic causes.
• David procedure: This involves reimplantation of the aortic valve. This is a bit more complicated than the Yacoub procedure, but it is more commonly used. It is especially suitable for young people with genetic diseases such as `Marfan syndrome`.

Who needs this surgery and when?

Anyone who has a swollen aortic root and is at risk of rupturing or tearing may need this surgery. Sometimes this condition occurs due to changes that occur with age. Also, genetic diseases such as Marfan syndrome and Loeys-Dietz syndrome can cause this dangerous aneurysm at a young age.

Surgery is usually recommended based on the size of the aneurysm and other risk factors.

• If there are no other genetic diseases or risk factors, the diameter of the aneurysm exceeds 5.5 centimeters .
• If you have Marfan syndrome, the diameter is greater than 5.0 centimeters .
• If you have Marfan syndrome, a family history of this type of aneurysm, are planning to become pregnant, or if the aneurysm is growing faster than 3 millimeters per year, surgery may be recommended even if it is 4.5 centimeters in diameter.
• If you have a bicuspid aortic valve (only two cusps) and other risk factors, such as high blood pressure, surgery may be recommended at a diameter of 5.0 centimeters .

How do you prepare before surgery?

Since this is a major surgery, it requires careful preparation. Your doctor will examine you thoroughly and order several necessary tests.

• Blood tests: Check kidney function.
• CT or MRI scans of the heart: Examine all parts of the aorta.
• Coronary angiography: View the condition of the coronary arteries that supply blood to the heart.
• Duplex ultrasound: Check the health of the arteries in the neck (carotid arteries).

Also, you should definitely talk to your doctor about these things:

• About all the medications you take: This includes vitamins and even herbal products. Some medications may require you to stop taking them before surgery.
• About other illnesses you have: Things like high blood pressure need to be well controlled before surgery.
• If you smoke: You should stop smoking completely at least one month before surgery. Ask your doctor for help with this.

What happens during and after the surgery?

During the surgery, you will be put under anesthesia and completely asleep. Then you will be connected to a heart-lung machine (cardiopulmonary bypass) . This machine will do the work of your heart and lungs during the surgery.

The surgeon makes an incision in the middle of your chest, accesses your heart, removes the weakened part of the artery, and replaces it with a new artificial channel (graft). The coronary arteries that supply blood to the heart are then connected to the new channel and the incision is sewn shut. This surgery usually takes between 4 and 6 hours .

After the surgery, you will need to stay in the intensive care unit (ICU) for a few days. Then you will be transferred to a regular ward. The entire hospital stay may take about a week. During this time, you will be given painkillers, blood thinners, and other necessary treatments.

How long does it take to recover?

It can take about 6 to 12 weeks , or maybe two to three months, to fully recover from this surgery. This is a major surgery, so you need to give your body time to heal.

• For 6 weeks: Do not drive or lift heavy objects.
• For an office job: You will be able to return in about 6-8 weeks.
• For a physically demanding job: You have to wait longer.

Following your doctor's instructions exactly and participating in cardiac rehab programs will greatly help with a speedy recovery.

When to see a doctor immediately

After returning home, if you develop any of the following symptoms , call your doctor immediately.

How to recognize an emergency?

If you have an untreated aneurysm, the following symptoms may be a sign of rupture or rupture. In such a case , immediately go to the nearest hospital Emergency Department (ETU) or call the 1990 ambulance service.

• Sudden, unbearable pain in the chest or upper back (feeling like something is being torn from inside the body).
• Sweating and feeling clammy.
• Difficulty breathing.
• Dizziness or fainting.
• Rapid heartbeat.