Scared about Aorta Surgery? Let's talk about it simply!

Let's talk about the largest and most important blood vessel in your body. We call it the "aorta." Think of it like the main pipe that carries water from the water tank to the kitchen and bathroom in our house. It is through this aorta that clean, oxygen-rich blood is distributed throughout the body. But sometimes this main vessel can have problems. Its walls can become weak and swell like a balloon, or it can suddenly rupture. That's when doctors talk about an "aorta" surgery. The name sounds a little scary, but let's understand it very simply.

What is Aorta Surgery?

Simply put, an aorta bypass surgery is a procedure to repair a defect or damage in this major blood vessel in your body. It connects to the heart, runs from there through the chest to the abdomen, and then branches off into the arteries that supply blood to the legs.

When the walls of this aorta become weak for some reason, the pressure of the blood gradually stretches it and starts to bulge like a balloon . In medicine, we call this an aneurysm . At other times, the lining on the inside of the artery wall can tear, and blood can leak between the two layers . We call this a dissection . The aorta that is swollen or torn in this way can suddenly burst (rupture) . If that happens, it is a very dangerous situation for life. So the main goal of this surgery is to correct this problem before such an accident occurs.

In what cases is this type of surgery necessary?

Your doctor will recommend this type of surgery if the aneurysm is larger than a certain size, or if it is growing faster than normal. This size is determined by carefully weighing the risks of surgery and the potential harm of not having surgery. The condition of the heart valve, especially if the aorta is bulging close to the heart, also affects this decision.

There are several reasons why the aorta can bulge or rupture in this way:

• Thickening and hardening of the artery walls: We call this `Atherosclerosis`.
• High blood pressure: That means `Hypertension`.
• Connective tissue diseases: For example, conditions like `Marfan Syndrome`.
• Injuries caused by accidents.

Aneurysms are divided into several types depending on where they occur.

How serious is aortic surgery?

Actually, this is a serious operation . Because the aorta is the main blood supply to the entire body. If its function stops even slightly, the entire body will malfunction.

But there is something very important to understand here. The success and safety of elective surgery, which is planned and prepared in advance, is much higher than emergency surgery, which is performed when an aneurysm is about to burst. Those who undergo surgery before it bursts have a much greater chance of saving their lives.

How is the surgery performed? What are the methods?

Depending on your condition, the doctor has several main ways to perform this surgery.

1. Open Surgery: In this, the surgery is performed by making a cut in the middle of the chest (sternotomy), by opening the chest between two ribs (thoracotomy), or by cutting the abdomen. This is the traditional method.

2. Minimally Invasive or Endovascular Method: This is a newer technique. It does not involve making a large incision. Instead, a small hole is made in a blood vessel in the groin, and a device called a stent graft is inserted through a catheter into the artery.

Think of it like repairing an old water pipe by putting a new one inside. This stent is a tube made of metal mesh and a special fabric. When it is placed inside the aneurysm, blood flows through this new tube. Then the pressure of the blood does not hit the weakened wall that has been bulging. Therefore, it stops bursting.

What are the advantages of the endovascular method?

• The time spent in the hospital is short.
• This is a better option for those who cannot bear the risk of open surgery.
• Since there is no major incision, the healing time is very short.

How do you prepare before surgery?

There are a few things you need to do before the surgery.

• Tell your doctor about all the medications you take (even those not prescribed by a doctor). Some medications may require you to stop taking them a few days before surgery.
• Get all the tests and blood tests your doctor orders, such as EKGs and CT scans, done on time.
• Arrange for someone to help you get to and from the hospital. It's also a good idea to have someone to help you for the first few days after surgery when you get home.
• Ask your doctor exactly what time you should stop eating and drinking the night before surgery.

What happens during and after the surgery?

The type of surgery will vary depending on the problem with your aorta and the type of surgery. Typically, the surgeon will remove the damaged, bulging part of the artery and replace it with a graft made of a synthetic material such as Dacron .

In some complex cases, especially if the aneurysm has spread from the chest to the abdomen, special techniques such as the two-stage "elephant trunk" procedure are even used.

After the surgery, you will first be admitted to the intensive care unit (ICU) . When you regain consciousness, you may have a breathing tube in your throat. It will be removed when you are able to breathe on your own. You will be able to start walking slowly. Then you will be transferred to a regular ward. The doctor will tell you when you are ready to go home.

How long does it take to recover? What are the risks?

Recovery time varies depending on the nature of the surgery.

• After open surgery: You will usually have to stay in the hospital for about a week. It can take about two to three months to fully recover.
• After Endovascular: You only need to stay in the hospital for a day or two. A short period of time, about two to three weeks, is sufficient for full recovery.

As with any major surgery, there are risks. Complications such as bleeding, stroke, heart attack, kidney failure, infection, and blood clots can occur. However, these risks can be minimized with a well-planned surgery performed under the supervision of a skilled medical team.

If you experience the following symptoms after surgery, you should inform your doctor immediately .

After surgery, you will have regular follow-up visits with your doctor. They will then do a CT or MRI scan to check the condition of the graft and any other problems with the aorta.