Aortic Aneurysm Repair

The aorta is the largest artery in the body, responsible for transporting oxygenated blood from the heart to the rest of the body. An aortic aneurysm occurs when a weak area on the aorta becomes enlarged and bulges outward, with the potential to cause serious problems if left untreated.

Living with an aortic aneurysm can be emotionally challenging, as patients and their families often worry about the risk of a sudden emergency. Gleneagles Hospitals understands the severity of these issues. The hospital offers diagnosis and care from specialists and provides patients with the information they need to make decisions with understanding and certainty. 
 

Aortic aneurysms typically form in the thoracic and abdominal regions. The most serious event is the rupture of an aneurysm, which results in a potentially life-threatening situation requiring an emergency intervention.

Aortic Aneurysm Repair (AAR) aims to repair the weakened portion of the aorta in order to help minimise the risk of rupture. There are two primary treatment options for AAR.

• Open surgery: A long-lasting synthetic graft is used to replace the section of the aorta that is diseased, and this is done through a surgical incision.
• Endovascular Aneurysm Repair (EVAR): This is a minimally invasive procedure in which a stent graft is inserted through the femoral artery to reinforce the weakened section of the aorta. 
   

Not every aortic aneurysm requires immediate surgery. Smaller aneurysms can often be monitored with regular imaging until treatment becomes necessary.

Surgical intervention is most often recommended when the size meets the following criteria:

• The aneurysm is 5.5 cm (men) or 5.0 cm (women).
• The aneurysm has grown by 0.5 cm within six months.
• Symptoms may develop, such as back pain or abdominal discomfort with a pulsating mass.

Timely surgical repair significantly improves patient outcomes and greatly reduces the risk of aneurysm rupture.
 

After a comprehensive evaluation, specialists determine the safest and most effective treatment approach.

An examination generally consists of:

• Computed Tomography Angiography (CTA): An in-depth evaluation of the aorta.
• Magnetic Resonance Angiography (MRA): A study of blood flow and aneurysm structure is performed.
• Electrocardiogram (ECG): Study of the electrical activity of the heart.
• Blood tests: To assess kidney function, blood clotting ability, and overall health.

These tests will be evaluated by the specialists at Gleneagles Hospitals, and the treatment plan will be formulated to reduce the risk of surgical complications.

Some medical conditions may require that surgery be postponed or the treatment approach be modified.

• Active systemic infections
• Severe heart failure
• Recent heart attack
• Advanced kidney failure
• Severe chronic obstructive pulmonary disease (COPD)

The treatment approach may also be modified if the blood vessels are too narrow, heavily calcified, or excessively tortuous to be treated with the Endovascular Aneurysm Repair (EVAR) technique. In this case, open surgery or a hybrid procedure may be the advised choice.

Preparation

Patients are required to fast for a specified period before the procedure. A thorough review of their current medication will be performed, and any blood-thinning medications may be temporarily stopped. The site of the procedure will be prepped, and antibiotics will be administered to reduce the risk of infection.

During the Procedure

Depending on the procedure selected, the methods will vary.

During open repair, the surgeon makes an incision in the chest or abdomen, temporarily clamps the blood vessels, excises the damaged area, and then replaces the damaged section with a durable synthetic graft.

For EVAR, small cuts are made in the groin. Stent-grafts will be implanted into the aneurysm via catheterisation through the femoral artery and fluoroscopy. The stent-graft allows blood to flow through the stent-graft rather than through the weakened aneurysm and reduces wall tension along the aneurysmal vessel.

The recovery rate will vary by treatment method.

Open repair patients often stay in intensive care for several days, in the hospital for one week and need to recover for 2 to 3 months.

Patients undergoing EVAR generally recover faster. Most patients go home within 2-3 days and return to normal activities sooner. Walking is encouraged to reduce the risk of blood clots, but avoid heavy lifting and strenuous exercise for a few weeks.

As with any major vascular surgery, there are risks associated with aortic aneurysm surgery. Short-term complications may involve:

• Bleeding requiring transfusion
• Wound infection
• Kidney function impairment
• Damage to the surrounding blood vessels.

Following EVAR, patients also require lifelong imaging because an endoleak may develop, allowing blood to flow into the aneurysm sac outside the stent graft. Follow-up is important for identifying and treating this complication early.

The aneurysm can suddenly rupture, causing severe internal bleeding that can quickly become life-threatening. Repair prevents rupture, restores normal blood flow, protects vital organs and significantly improves long-term survival and reduces the risk of aneurysm rupture.

Multidisciplinary Expert Care

The team of vascular surgeons, cardiologists, interventional radiologists and cardiac anaesthetists at Gleneagles Hospitals work together to provide tailored treatment.

Advanced Hybrid Operating Theatres

With advanced imaging and modern surgical facilities, specialists can seamlessly perform both minimally invasive and open procedures in the same operating theatre when required.

Comprehensive Care

Patients receive comprehensive support pre- and post-surgery, including structured recovery plans, regular imaging, blood pressure checks, kidney function testing, and long-term graft surveillance.

Aortic aneurysms can be fatal, but life-threatening complications can typically be avoided when these disorders are recognised and treated quickly. With state-of-the-art technology, skilled vascular surgeons and staff, and a commitment to excellence in patient care, Gleneagles Hospitals provides comprehensive care for aortic aneurysm repair, from accurate diagnosis and advanced treatment to long-term follow-up and recovery.