Mercy Cardiothoracic Surgical Associates
Thoracic Aortic Disease
The thoracic aorta is the larger artery that carries blood from the heart to the rest of the body. When it becomes weakened as a result of genetic conditions or disease it can dissect, result in an aneurysm, or rupture. Patients at greater risk for TAD include men, the elderly, and people with poorly-controlled high blood pressure, atherosclerosis, inflammatory disease, or a congenital disease such as Marfan’s Syndrome. At-risk patients may be prescribed medical therapies including drugs to control blood pressure, heart rate, and statins to lower elevated blood cholesterol levels.
- Aortic Dissection Repair
An aortic dissection occurs when the inner lining of the heart’s arterial wall splits. As blood is pumped through the heart it spills out through this small opening and builds up in the vessel wall. With enough blood build-up the pressure can cause the outer lining of the artery to rupture. An arterial tear can go back toward the heart (called a proximal aortic dissection) or, more commonly, away from the heart (distal aortic dissection). Aortic dissections can be caused by congenital arterial weakness, high blood pressure, and arteriosclerotic vascular disease. Common symptoms of aortic dissection include:
An aortic dissection can be diagnosed with a CT (computed topography) scan. Minimally invasive endovascular surgical techniques may be an option for some patients with a descending thoracic aorta dissection.
- Intense, “stabbing” pain in the chest, jaw, back or neck
- Cold “sweats”
- Numbness or tingling in arms or legs (due to lack of blood supply)
- Mental confusion (due to lack of blood supply to the brain)
- Thoracic aortic aneurysm resection
In a thoracic aortic aneurysm the aorta wall becomes weak, generally due to high blood pressure, atherosclerosis, or a congenital condition. The disease process causes the blood vessel wall to balloon. Resecting an aneurysm is a surgical procedure where the swollen part of the artery is removed and then splicing the two ends with a synthetic graft.
Aneurysm symptoms vary depending on the location, however often patients with an aortic aneurysm may have no symptoms until it ruptures.
- Thoracic aortic stent grafting
Endovascular stent grafting involves threading a stent graft through a small opening in the patient’s femoral artery (located in the groin). Using a fluoroscope the surgeon guides the stent graft to the site of the aneurysm in the descending thoracic aorta. Once the stent graft is in place it fits within the aorta to create a new path for improved blood flow. Thoracic aortic stent grafting may be recommended for specific patient groups including patients who are elderly, obese, and/or respiratory-challenged.