Valley Cardiac Surgery

Aortic Surgery

Thoracic aortic aneurysm is a weakening in some portion of the thoracic aorta, resulting in thinning and dilation of the aortic valve.

Risk factors: Hypertension, cigarette smoking, elevated blood cholesterol, family history of aneurysms, trauma, infections.
Onset: Aortic aneurysms are more common in men and the incidence more prevalent over the age of fifty.
Diagnosis: May be an incidental finding during a routine chest x-ray, but frequently is not identified until signs or symptoms develop. These may vary, depending on the location of the thoracic aneurysm, but are generally shortness of breath, cough, shoulder or back pain.

Thoracic aortic aneurysm rupture is a true medical emergency. Signs and symptoms include severe chest and back pain, low blood pressure and rapid heart rate. Surgery involves removal of the section of involved aorta and replacement with a synthetic graft. Cardiopulmonary bypass is usually required.

Aortic Dissection involves a tear in one of the aortic wall layers, resulting in bleeding within the layers. Blood is then redirected from the true lumen of the aorta into this false channel.

Risk factors: Hypertension, including hypertension associated with pregnancy.
Onset: Most often occurs after the age of sixty. Men are more frequently affected.
Diagnosis: Most patients describe severe pain along the path of dissection. It is often reported as a “ripping” or “tearing” pain in the chest, radiating to the back. Other signs and symptoms are related to the interruption of blood flow into the false channel and are varied, depending on the location within the aorta.

Surgery is the treatment of choice if the dissection involves the ascending thoracic aorta (first section of the aorta as it emerges from the heart). Repair involves excising the tear, repairing the false lumen and restoring the true pathway of blood flow. Cardiopulmonary bypass is required.

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