Aortic Arch Aneurysm Repair

Open Surgery for Aortic Arch Aneurysm

For large aortic arch aneurysms, your care team surgeon may recommend an aortic arch replacement, which is an open surgical procedure in which the aortic arch is surgically removed and replaced with a synthetic graft.

What Happens During Open Surgery for an Aortic Arch Aneurysm?

You will be connected to a heart-lung bypass machine, which helps the heart continue circulating blood throughout the body. Your surgical team will make an incision, called a median sternotomy, through your breastbone. The surgeon will then replace the diseased portion of your aortic arch with a synthetic graft.

As part of the procedure, the arch blood vessels that supply blood to the brain and other organs of the upper body are reconnected to the synthetic graft. In some cases, only the underside of the aortic arch is replaced with a graft. Known as the hemiarch technique, part of the aortic arch that contains the arch blood vessels is left in place.

During the procedure, your surgeon will also examine the aortic valve to determine if it needs replacement, in which case the valve is replaced at the same time as the aneurysm surgery.

Recovery from Open Surgery

Full recovery from aortic arch aneurysm open surgery usually takes two to three months. You should plan to be away from work for at least six to eight weeks while you regain your full strength. Your doctor will advise you on post-operative restrictions, including participation in a cardiac rehabilitation program if they feel it will be beneficial to your recovery.

Endovascular Aortic Arch Repair

Many patients with aortic arch aneurysms and other types of complex aortic aneurysms are too medically fragile for open surgery. The Nexus endograft marks a new era in the minimally invasive management of complex aortic arch disease, including treatment of aortic arch aneurysms and dissections.

UH Harrington Heart & Vascular Institute is one of a few locations in the country to offer endovascular aortic arch aneurysm repair. We are the only center in Northeast Ohio and one of two in the state to test the innovative Nexus^® aortic arch stent graft system for the treatment of aneurysms and other aortic pathologies through an ongoing clinical trial. Nexus is the first off-the-shelf stent graft designed for total endovascular aortic arch repair.

Endovascular aortic arch repair is a two-stage process:

• Stage One: The surgeon makes a small neck incision, rerouting blood flow to the brain and upper extremities by bypassing certain arteries. This technique makes open-chest surgery unnecessary.
• Stage Two: Performed two to three days later, the surgeon implants several stent grafts in the aorta. Most patients are able to return home a couple of days after the procedure.

Endovascular aortic arch repair with the Nexus stent graft system can be adapted according to a patient’s unique anatomy. The stent graft provides a lasting, durable repair while reducing risk of postoperative complications due to its minimally invasive placement. Other benefits of the procedure include:

• Reduced risk of infection
• Improved patient comfort
• Procedural consistency
• Optimized health care resource utilization