TEVAR surgery for thoracic aortic disease? (Thoracic Endovascular Aortic Repair) Let's understand it simply

Have you ever thought about the largest blood vessel in our body? Just like the main water pipe that brings water to our house, the main blood vessel that carries blood to every organ and cell in our body is the aorta, or as we call it, the aorta . This is a very strong vessel. But sometimes, just like the side of an old car tire becomes weak and bulges like a bubble, the wall of this aorta can also become weak and bulge in one place. Or its inner layer can even tear. These are very dangerous conditions. But don't worry, with the advancement of medical science, there are now very effective treatments for this. That is what we are talking about today.

What is this TEVAR surgery?

Simply put, TEVAR (Thoracic Endovascular Aortic Repair) is a minimally invasive surgical procedure used to repair damage to the thoracic aorta.

Imagine how this kind of disease was treated in the past. Doctors had to completely open up the chest and perform major surgery to repair this damage. It was very complicated, took a long time to heal, and was very risky.

But in the TEVAR method, such a large incision is not made. Instead, a very small incision is made in the groin, a thin tube (catheter) is inserted through it, and a special device is passed through that tube to repair the weakened part of the aorta. This is similar to how a pipe that runs inside a house wall breaks and a smaller pipe is inserted inside the pipe without breaking the wall. This results in very short healing time, less pain, and less risk.

In what cases is TEVAR surgery necessary?

Doctors mainly use this surgery to treat several serious conditions that occur in the aorta. Let's take a look at what they are.

How do you prepare before surgery?

If you decide to have this type of surgery, your doctor will explain to you clearly how you need to prepare for it. You may usually be asked to do things like:

• Blood pressure and cholesterol control: You may be given medication to help control these.
• Avoid smoking: If you are a smoker, you need to stop it completely.
• Medication changes: You may be asked to stop or change some of the medications you are currently taking for a while before surgery.
• Special tests: The doctor will need to perform several tests to plan the surgery.

Preoperative tests

The most important of these tests is a CT Angiogram . This is a special CT scan. It can clearly see the size and condition of your aorta and other blood vessels used for surgery.

Imagine, the surgical tube is inserted through a blood vessel in the groin. If that blood vessel is too narrow, or if it is blocked by cholesterol deposits, the tube cannot be passed through. This scan helps to detect such things in advance.

Also, the measurements from this scan are very important for choosing the right size stent graft for the damaged area in your aorta.

What is a stent graft?

This is the hero of this surgery. A stent graft is a tube made of a fabric-like material. It has a metal mesh inside. It is folded up and then passed through the aorta. When it reaches the right place, it opens like a spring and attaches tightly to the wall of the aorta.

What happens is that blood flows through this new tube. The weakened, swollen wall of the aorta doesn't have the pressure from the blood. So it stops bulging. It's like putting a new lining inside the aorta.

How is the surgery done?

You must be very curious about this. Let's take a look at the simple steps involved in the surgery.

1. Sedation: First, you will be put under general anesthesia, or only the area where the surgery will be performed will be numbed, and you will be given medication to relax.

2. Small incision: Next, a small incision is made in the skin, usually in the groin area, and the blood vessel (femoral artery) located there is accessed.

3. Guide wire: A thin wire (guide wire) is passed up this blood vessel, past the damaged area of ​​the aorta, and then stopped.

4. Catheter and stent: Then, a tube (catheter) is passed along the wire. The folded stent graft is inside this tube. All this is done under the guidance of a special X-ray machine (fluoroscopy).

5. Stent placement: Once the tube is in the correct position, the doctor will carefully insert the stent graft. It will then automatically expand and attach to the wall of the aorta.

6. Finishing: After that, the tube and wire are taken out, and the small incision made in the groin is closed with stitches.

Usually, this entire process takes about two hours.

What are the benefits and risks of TEVAR surgery?

As with any medical procedure, there are benefits and risks, but the benefits of TEVAR surgery far outweigh the risks.

Your doctor will explain these risks to you thoroughly, and they will take every step possible to minimize them.

How is the recovery time after surgery?

After the surgery, you will be kept in the intensive care unit (ICU) for observation for a day or two, and then transferred to a general ward. If everything goes well, you will be able to go home in a few days. Here are some things to keep in mind after you go home:

• Driving: Avoid driving for one to two weeks.
• Bathing: Avoid soaking in a tub of water until the groin wound has healed. Taking a shower is fine.
• Weight lifting: Do not lift more than 10 pounds (about 4.5 kg) for one to two weeks.

Lifelong follow-up is important!

This is the most important point . After TEVAR surgery, it is essential to see your doctor for checkups throughout your life. Usually,

• One month after surgery
• Then in six months (if there was a problem at the first check-up)
• A year later
• Then once every year

You will need to have a scan. This is done to check if the stent is in the right place, if there are any problems with it, if there are any blood leaks. Don't skip this. This is very important for your safety.

What time should I call the doctor?

If you have any questions or concerns about your treatment or recovery time, don't be afraid to talk to your doctor. Also, if you experience sudden symptoms of a heart attack or stroke (e.g., severe chest pain, shortness of breath, difficulty speaking, or weakness on one side of the body), go to a hospital's Emergency Department (ETU) immediately.

TEVAR is a remarkable advancement in medical science. It has helped to treat conditions that were once life-threatening, today, with much less risk and with much less risk. If you or someone you know has this condition, don't be afraid to talk to a doctor and decide on the best treatment option for you.