Aortic surgery is the operations performed in the diseases and dysfunctions of the aortic vessel that comes out of the heart and serves to carry blood to the whole body. These surgeries are most commonly performed in the case of aneurysms of the aorta (enlargement and ballooning of the aorta). Some other important conditions that will require surgery are aortic coarctation (narrowing of the aortic vessel) and aortic dissection (rupture of the aortic vessel). In aortic vessel problems, the diseased part of the aorta is removed with surgical procedures and artificial vessels are placed in its place.
What is the Aorta?
The aorta is the body's largest main artery. This vein, also called the aorta in medicine, is an arterial network that comes out of the heart and resembles the branches of a tree. The aorta provides the distribution of clean blood from the heart to the whole body and is approximately 3-3.5 cm in diameter. This diameter ratio gets smaller as it moves towards the abdomen. Through the aorta, especially the heart; Clean blood is pumped to the head, trunk, arms, legs and the whole body. Inside the aorta is oxygen-rich blood from the lungs. Thus, oxygen-rich blood reaches the cells and enables tissues and organs in the body to perform their functions. The aorta takes different names according to the region where it is located. The part of the thorax is called the thoracic aorta, and the part of the body that is lower in the abdominal cavity is called the abdominal aorta.
Aortic aneurysm is an abnormal ballooning of the walls of the arteries. The reason for the formation of aneurysms may depend on many factors and may differ from person to person. Aortic aneurysms mostly occur as a result of genetic predispositions. Another cause of aneurysm is a condition known as hardening of the arteries. Excessive smoking is another factor that causes aortic aneurysm. Ballooning that causes aneurysm is named using different names depending on where it occurs. Of these aneurysms located in the chest cavity; It is called thoracic aortic aneurysm, and those in the abdominal cavity are called abdominal aortic aneurysms. Aortic aneurysms may have no obvious symptoms unless the aortic artery ruptures. Sometimes due to routine controls or other complaints. It is determined by chance during examinations with Some common symptoms of aortic aneurysm are as follows:
- Increased blood pressure
- Increased cholesterol values
- Pain and tenderness in the chest
- Back, neck and jaw pain
- Dortness of breath
- Cough and hoarseness
- Difficulty swallowing
Functions of the Aortic Vein
The most basic function of the aorta is that it is the main artery responsible for taking the blood necessary for life from the heart and distributing it to the whole body. The aorta is very flexible, durable, and strong, and it functions smoothly for many years in a healthy person. The flexible structure of the aorta allows it to withstand high pressure levels in the blood. Even if it has to pump blood at high pressure in the event of a trauma or accident, it can expand like a plastic balloon and regain its former shape. There are some issues that need to be considered in order to keep the aorta healthy and to perform its functions correctly. Some suggestions that will reduce the risk of aortic diseases and protect the general health of the aorta are as follows:
- Eating Healthy: Cholesterol occurs naturally in the body; however, its elevation can cause narrowing and occlusion of the heart vessels. Nutrition program to keep cholesterol and other blood parameters under control and to protect general heart health; Adding whole grains, legumes, fiber foods, fresh vegetables and fruits, and various omega-3 sources may be beneficial.
- Smoking: Smokers are more likely to have aortic aneurysms than non-smokers. For this reason, quitting smoking can reduce the risk of aortic and other heart diseases. For this reason, it is important to keep high blood pressure under control. For this, limiting the consumption of salt and alcohol, doing regular sports and reducing stress, in addition to the medications used by the doctor's recommendation, may also help to control blood pressure. For this reason, the pressure on the veins Heavy lifting should be avoided.
- Achieving Weight Control: Excess weight can disrupt the vascular structure and create a blood pressure problem. In this case, the risk of aneurysms may increase. For this reason, maintaining weight control and exercising regularly may be beneficial in reducing this risk.
Aortic Surgery
Aortic surgery is the surgery performed in case the aortic vessel enlarges and balloons. includes interventions. The main goal of this surgical method is; It is the replacement of the diseased vein with an artificial vein. With this method, the patient's vital functions are maintained. Aortic surgeries; These are usually difficult, long-lasting and complicated surgeries. However, with the development of technology in recent years, the ballooning vessel is repaired by entering through the groin or another vessel with the method called endovascular stent. The chance of success of the surgery performed with this method increases and the possible risks of surgery can be reduced. Thanks to aortic surgery, patients are protected from rupture of aortic vessels and the risk of death.
There are some negative factors that cause aortic vessel disease and require aortic vessel surgery. Due to these factors, the aortic wall weakens and some aneurysms occur. In this case, the aortic vessel may become inoperable and may pose a life-threatening risk. Some conditions that impair the function of the aorta are as follows:
- Genetic Predispositions: Aortic diseases due to genetic predispositions may start to be seen at a young age in people with family members of aortic disorders.
- Heart Diseases: Aorta Aneurysms and other aortic diseases may be more common in people with existing heart disease. The most common cause of these diseases is atherosclerosis, also known as atherosclerosis.
- Infections: Some infections can damage the arterial walls by disrupting the function of the aorta. These infections usually include syphilis and salmonella infections.
- Some Hereditary Diseases: Some inherited diseases can lead to aortic diseases. These hereditary diseases; Marfan syndrome, Loeys-Dietz syndrome, Turner syndrome and Ehlers-Danlos syndrome can be given as examples. It can develop more in advanced ages such as 70 years.
Diseases Treated in Aortic Surgery
Although the aorta is strong and durable due to its structure, it weakens in some genetic conditions. and gets sick. Diseases of the aorta are named differently depending on their location and may give different symptoms. Diseases treated in aortic surgery are as follows:
Thoracic Aortic AneurysmThoracic aortic aneurysm is an aneurysm occurring in the chest cavity. This may be caused by genetic connective tissue disorders, as well as by high blood pressure and sudden trauma. Some symptoms of a thoracic aortic aneurysm are as follows:
- Sharp pain in the chest and upper back
- Difficulty breathing
- Difficulty swallowing
- Dizziness or fainting
- Pain in the back and sides of the trunk
- Pain in the hip and groin
- Pain in the legs
Treatment Methods in Aortic Surgery
The main treatment method used in aortic surgery is surgery. However, in some cases, doctors may also prescribe medication before surgery. Drug treatments are mostly used for patients with small aneurysms. Aortic vessel surgeries are generally open surgery and endovascular repair. The procedures of these methods are as follows:
- Open Surgery: Open surgery is the most effective method of treating aortic aneurysms. The surgeon performing the operation removes the dysfunctional aorta and He puts an artificial vein (artificial graft) into his blood. Aortic vessel surgery is performed under general anesthesia and the operation can take between 2 and 6 hours. After the operation, the patient can stay in the hospital for approximately 1 week and then discharged. It may take an average of 1 month for the patient to return to his normal life. After the surgery, the doctor may start some drug treatments. These are usually blood thinners and diuretic drugs. During the recovery period, there may be chest pain and difficulty in breathing. However, all symptoms usually resolve after 1-3 months of operation, unless complications develop.
- Endovascular Repair: Endovascular repair is supportive treatment for weakened aortic vessel. The surgeon places the prosthesis, called a stent graft, into the aorta with a very thin tube or catheter. This process helps the aorta to perform its function; however, it is not applied in all aneurysms. Endovascular repair can be performed under general anesthesia or local anesthesia, depending on the patient's condition. Patients usually stay in the hospital for 1-2 days. Complete recovery may take 4-6 weeks.
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