Have you heard of the largest and most important blood vessel in our body? We call it the aorta. Just like the main water pipe that brings water to our house, this aorta carries clean blood from the heart to the entire body. But sometimes, a weak spot develops in the wall of this aorta, and that area starts to bulge like a balloon. That's what we call an 'aneurysm'. If this bulge occurs in the aorta in the chest, it's called a 'Thoracic Aortic Aneurysm'. This may sound a little scary, but don't worry. Let's talk about everything clearly and simply.
What is a Thoracic Aortic Aneurysm?
Simply put, this is a bulge that occurs in a part of the thoracic aorta inside our chest. Imagine an old water pipe, one part of it is weak and it bulges out a little. That's what happens here too. This is actually a rather rare condition, only one in ten thousand people have this condition.
Most of the time, no one knows they have this swelling. It is discovered incidentally during a test, such as a CT scan, done for another reason.
Should everyone have this surgery?
No. Not everyone with this type of swelling will need surgery. There are several factors that will determine whether you need surgery or not.
- Size of the bulge: How big this is is very important. Generally, if it is larger than 5.5 centimeters, surgery should be considered.
- Growth rate: If this swelling grows faster than 0.5 centimeters within six months, that is also a reason to seek surgery.
- Your symptoms: Some people may experience symptoms like chest pain and difficulty breathing.
- Your overall health: Your age and whether you have other medical conditions also affect the decision about surgery.
After considering all of this, your doctor will decide what is best for you.
There are two types of surgery: let's see what they are
There are two main surgical procedures to treat this condition. See the table below to understand the difference between the two.
| Feature | 1. Open Thoracic Aneurysm Repair | 2. TEVAR method (Thoracic Endovascular Aortic Repair) |
|---|---|---|
| How to do it | A long incision is made on the side of the chest, the damaged part of the artery is removed, and an artificial tube (graft) is implanted in its place. | A small incision is made in the groin, a thin tube (catheter) is passed through it along a blood vessel, and a mesh-like device (stent) is inserted into the swollen area to strengthen it from the inside. |
| Cut | A large, long incision is needed. | Only a very small incision is required. |
| Time in the hospital | It may take up to 10 days. | Usually about 3 days. |
| Time to heal | It takes about 2-3 months to get back to normal life. | You can do normal work in a few weeks. You need to wait about a month for heavy work. |
Why is this surgery so important?
The main reason for doing this surgery is to reduce the risk of the aneurysm rupturing . Not all aneurysms rupture. However, if they do, it is a life-threatening emergency.
Although there are some risks involved in surgery, the risk of the artery bursting is much greater. That's why doctors recommend surgery at the right time.
What happens before the surgery?
Your doctor will give you the necessary instructions before the surgery.
- Tests: The size and condition of the swelling are constantly monitored by doing things like a `CT scan`.
- Medication: You may be given medication to control your blood pressure and relax your blood vessels a few days before surgery.
- Anticoagulants: If you are taking anticoagulants, your doctor will advise you to stop taking them shortly before surgery. Never stop taking these without medical advice.
What happens after the surgery?
After open surgery, you will be monitored in the intensive care unit (ICU) for a day or two. Then you will be transferred to a regular ward and will have to stay in the hospital for about 10 days.
After a TEVAR surgery, you will usually have to stay in the hospital for about three days. The doctors will give you medication to help with the pain after the surgery.
What are the possible risks of this surgery?
Although this is a life-saving surgery, like any major surgery, there are risks involved. However, the medical team is doing its best to minimize these risks.
- Bleeding
- Lung infections (pneumonia) or other breathing problems
- Heart attack
- Stroke
- Decreased kidney function
- Infection at the surgical site
- Weakness in the legs due to impaired blood supply to the spine
Don't be alarmed when you hear these things. These are just possible things to happen . Talk openly with your doctor about this and ask any questions you have.
When to see a doctor after surgery
When you go home after surgery, it is very important to be aware of any signs of complications as soon as possible. If you have any of the symptoms below, call your doctor immediately.
| Symptom | What to pay attention to |
|---|---|
| Fever | If the body temperature is higher than 100.4 F (38 C). |
| Changes around the cutting road | Severe redness, swelling, or a lump forming around the incision. |
| Pain | Severe pain that persists despite taking medication. |
| Swelling | Unusual swelling in the surgical area or legs. |
Both of these surgeries are highly successful treatments. In the TEVAR procedure, the stent can be placed 99% successfully. Open surgery is also very successful. The most important thing is to understand that this is something that is done to save a life.
Take-Home Message
- Thoracic aortic aneurysm is a weakening and bulging of the chest portion of the main blood vessel leading from the heart.
- The main reason for this condition is the weakening of the arterial wall.
- Whether or not surgery is needed depends on the size of the bulge, how quickly it grows, and your health condition.
- There are two treatment methods: open surgery and TEVAR, which involves inserting a thin tube through the groin.
- The main reason for performing this surgery is to prevent the dilated artery from bursting and causing life-threatening damage.
- It is very important to follow the doctor's instructions exactly after surgery and to notify the doctor immediately if you notice any unusual symptoms.
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