Aortic Aneurysm & Aortic Dissection

What is it?

Simply put, an abnormal dilation of the big blood vessel (Aorta) which comes out of the heart and supplies the whole body is called an Aortic Aneurysm.

Usually the aorta is 2.2 - 2.5 cms. Due to various conditions like atherosclerosis, genetic disorders and abnormalities of the heart valves, it can balloon out to more than 4.0 cms. When the size exceeds 5.0 cms, there is risk of rupture of the aorta which can lead to death instantaneously.

Who is at risk?

. Patients with high blood pressure

. Family history of aortic aneurysms

. Connective tissue disorders

When to see a Doctor?

. Chest pain and tightness

. Breathing difficulty

. Sometimes the aortic aneurysm may rupture and pose a threat to life.

What has to be done? (Surgical Intervention)

Surgery for this condition is technically difficult and needs a lot of expertise, skill and training.

The surgical team headed by Dr Anbarasu Mohanraj are quite skillful to deal with such complex conditions and the team has done plenty of such complex surgeries with good results.

The surgery may involve cooling down the body to 18 degree Celsius with the Heart Lung Machine and frequently involve stopping the circulation to the body and brain to complete the operation. This is called Total Circulatory Arrest. (TCA)

Aortic Root Replacement (Bentall & De Bono’s Procedure) is a surgery where the Aorta along with the Aortic valve has to be replaced en-bloc and the arteries supplying the heart (Coronary Arteries) have to be re-implanted to the new synthetic graft used to replace the Aorta.

• Thoraco-Abdominal Aneurysm

• Bentall’s Operation

The Aorta supplying the body and abdominal organs like liver and intestines may be involved and this condition is called Thoraco-Abdominal aneurysm. The surgery for this condition carries extremely high risk and complex. The surgery will involved replacing a long length of Aorta with synthetic graft and re-attaching major blood vessels supplying liver, kidney and intestines.

These surgeries are efficiently done, though complex, the results are quite encouraging.

Aortic Dissection

What is it?

A tear in the aorta may cause a life treating extension of the tear involving the whole of the aorta from the root of the heart involving blood vessels supplying the whole body. This is called Aortic Dissection.

Who is at risk?

. Uncontrolled Blood pressure

. Family history of Aortic dissection

• Connective tissue disorders like Marfans’s syndrome Bicuspid Aortic valve

When to See a doctor?

. Sudden tearing chest pain

. Breathlessness

. Life threatening low blood pressure

Surgical Intervention

This is a life threatening emergency and emergency surgery needs to be performed.

Once again this surgery - Repair of Aortic Dissection is a complex surgery as the Operation is technically demanding. The tear is repaired with a synthetic graft and patient may need to be Cooled to 18 degree Celsius and Total Circulatory arrest achieved.