Think of your heart as a water pump. The main, largest, and strongest tube that pumps water throughout your body is the aorta . This is the one that carries oxygen-rich, clean blood from your head to your legs. So if there is a problem with this important main tube, we are going to talk about surgery to repair it. It is normal to feel a little scared when you hear about this, but once you are properly informed, you can overcome that fear.
What are the main problems that arise in this aorta?
Simply put, there are two main problems that affect the aorta.
1. Aneurysm: Imagine an old water pipe bulging out like a balloon. In the same way, the walls of the aorta become weak and bulge out like a balloon due to the pressure of the blood passing through it. This is what we call an ``Aneurysm''.
2. Dissection: This is a little different. The wall of the aorta has several layers. What happens in this is that a small tear forms in the innermost layer, and blood leaks between those two layers. This is also a very dangerous condition.
If this aneurysm or dissection suddenly bursts, it can cause a lot of bleeding into the body and be life-threatening. That's why doctors try to repair it with surgery before it gets to that point.
Why do situations like this occur?
There are several reasons for this, some of which we can control, and some of which we cannot.
| Main reasons | A simple explanation |
|---|---|
| Atherosclerosis | The main cause is the buildup of cholesterol-like substances in the walls of blood vessels, hardening and narrowing the vessels. |
| Hypertension | High blood pressure, or pressure that remains high for a long time, can damage the walls of blood vessels. |
| Connective Tissue Disorders | These are genetic diseases. For example, people with diseases like Marfan Syndrome have weak body tissues, which can cause the aorta to weaken. |
| Injury caused by an accident | This type of damage can also occur due to a severe injury to the chest, such as a major car accident. |
How is surgery performed? What are the main methods?
The doctor will decide the most appropriate surgical procedure for you based on many factors, such as the severity of your condition and the location of the aneurysm. There are two main methods.
1. Open Surgery
This is the traditional method. Here, a sternotomy is made in the middle of the chest, or the abdomen is opened, to directly access the damaged part of the aorta. The damaged part is then removed and a graft made of a synthetic material such as Dacron is implanted in its place. This is a major operation, and it takes a long time to heal.
2. Endovascular / Minimally Invasive Surgery
This is modern technology. There is no large incision here. A small incision is made in a blood vessel through the groin, and a stent graft is sent through it with the help of a catheter (thin tube) to the damaged part of the aorta.
What is a stent graft?
This is like a small tube made of metal mesh and covered with a cloth. When this is placed inside the place where the ``(Aneurysm)`` is, the blood flows through this new tube. Then the blood flows without hitting the wall of the weakened aorta. Therefore, it stops bursting.
Advantages of the endovascular method:
- The number of days in the hospital is decreasing.
- This is a good option for those who cannot bear the risk of open surgery.
- Since there is no major incision, the healing time is very short.
How should you prepare before surgery?
It is very important to prepare well before surgery.
- Be sure to tell your doctor about all medications you take (even vitamins and herbal remedies). Some medications may require you to stop taking them a few days before surgery.
- Get all the tests your doctor orders, such as blood tests, EKGs, and CT scans, done on time.
- Arrange for someone to help you during your hospital stay and for the first few days after you return home.
- Find out exactly when you should stop eating and drinking the night before surgery.
What happens after the surgery? How long will it take to recover?
After surgery, you will first be admitted to the intensive care unit (ICU). When you regain consciousness, you may have a breathing tube inserted to help you breathe. It will be removed when you are able to breathe on your own. Once you are able to walk slowly, you will be transferred to a regular ward.
Recovery time varies depending on the type of surgery:
- If open surgery is performed, it may take about 2-3 months to fully recover.
- Endovascular surgery requires a two to three day hospital stay and a full recovery period of 2-4 weeks .
Risks of surgery and when to see a doctor immediately
Like any major surgery, there are some risks, but these don't happen to everyone.
- Excessive bleeding
- Stroke
- Heart attack
- Kidney failure
- Infections
- Loss of leg function (especially in lower chest and abdominal surgeries)
If you have any of these symptoms after returning home, you should call your doctor immediately:
- Redness, swelling, or pus oozing from the surgical wound
- Fever without a reason
- Severe chest pain
- Difficulty breathing
The most important thing is that the success and safety of a pre-planned surgery is much higher than an emergency surgery performed in the Emergency Treatment Unit (ETU) after an aneurysm bursts. Therefore, if the doctor recommends surgery, do not be afraid of it and take the necessary steps.
Take-Home Message
- Aortic surgery is a very important life-saving surgery, so don't be unnecessarily afraid of it.
- The success and safety of a planned surgery, rather than waiting until an emergency, is much higher.
- The modern ``Endovascular`` method is very effective. However, it is not suitable for every patient. Your doctor will choose the method that is most suitable for you.
- Following medical instructions exactly after surgery is essential for a speedy recovery.
- Talk openly with your doctor about any questions or concerns you have about your health, the surgery, or the recovery period.
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