Aortic Aneurysm Surgery includes two categories:
- Degenerative Aortic Aneurysms
- Dissecting Aortic Aneurysms.
Degenerative Aortic Aneurysms mainly happen due to Atherosclerosis which is characterized by the deposition of plaques of fatty material on the inner walls of arteries. This situation is usually seen in the middle-aged who are beyond 50 yrs. We do corrective repairs to these Aneurysms using Prosthetic Fabric Grafts or Biological Tissues and Valves that are available commercially.
The procedures include Bentall Operation, Hemiarch Replacement, ElephantTrunk Procedure, etc. We also do a procedure called Aortic ArchDebranching with Ascending Aortic Replacement. In certain situations where regular repairs are risky, we also do Hybrid procedures like Debranching with Stenting of the Arch and Descending Aorta.
Dissecting Aortic Aneurysms happen in situations of accelerated Hypertension or Connective Tissue Disorders like Marfan’s Syndrome. This is a condition in which the Inner Layer of the Aorta called the Intima is Torn and the Blood Seeps in between the layers of the Aorta leading to the Aortic Lumen getting split along its length into two forming a True Lumen and a False Lumen. This is a very lethal situation and the patient needs to be operated within 24 hrs of the onset of symptoms. We do Emergency dissection repairs which include either a BentallOperation or a Valve Sparing Root Replacement. In certain situations, we do a Hybrid procedure where we Surgicallydebranch the Aortic Arch and then the False Lumen is closed off by Stenting of the Dissected portion of the Aorta. In special situations, we even do a procedure called Frozen Elephant Trunk that uses a Hybrid Branched Graft with the Stent.
Our unit is specially equipped with all the gadgets including Cerebral Oximetry, Spinal Oximetry, TEE, which are used in surgeries of Aorta. Sometimes it is necessary to go into a Total Circulatory Arrest (stoppage of body circulation for some time) to facilitate our surgery. We do Antegrade Cerebral Perfusion so that these surgeries of Aortic Aneurysm can be done safely.
Moreover, wherever suitable we do preserve the native Aortic Valve called Valve Sparing Aortic Root Replacement.