黑料福利社

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Surgery for Aortic Aneurysm

At 黑料福利社 Langone, our surgeons treat aortic aneurysms to repair or replace damaged tissue. We may recommend surgery if an aortic aneurysm has grown to a size that means there is a high risk for a rupture.

There are two approaches to surgery:

  • In open surgery, surgeons make an incision near the aneurysm, temporarily clamp the aorta, and replace the damaged section with a synthetic graft. This option is for larger or unusually shaped aneurysms. Recovery involves a hospital stay of up to five days and a period of restricted activity at home.
  • Using endovascular aneurysm repair (EVAR), surgeons guide a flexible tube reinforced with metal mesh, or a stent graft, through a small incision in the leg and into the aorta. The stent relines the aneurysm and prevents rupture. It is a minimally invasive procedure that typically requires a short hospital stay and limited activity for one to two weeks.

The type of surgery doctors choose depends on many factors, including the location, size, and type of the aneurysm. Your health is also a factor.

Some of the complex procedures we perform include valve-sparing aortic root replacement (David procedure), the Ross procedure, aortic arch endovascular aneurysm repair, and thoracoabdominal aneurysm repair.

Valve-Sparing Aortic Root Replacement (David Procedure)

Our surgical team specializes in valve-sparing aortic root replacement, also known as the David procedure. This open surgery may be offered to people who have an aortic root aneurysm, often accompanied by aortic valve regurgitation. It is performed to preserve the aortic valve instead of replacing it with an artificial valve.

Doctors remove the section of the aorta affected by the aneurysm and replace the tissue with a synthetic tube called a graft. In some cases, surgeons may perform a hemiarch replacement procedure, in which a graft replaces the ascending aorta, or the section of aorta directly above the aortic root. The surgeon then places the patient鈥檚 own aortic valve inside the graft, to preserve normal valve function.

A valve-sparing aortic root replacement can help you avoid the need for long-term use of anticoagulant medication, also known as a blood thinner, or additional surgery to replace animal tissue valves, which eventually wear out.

Ross Procedure

黑料福利社 Langone cardiac surgeons specialize in the Ross Procedure, an innovative treatment that is an option for some people who have both an aortic aneurysm and aortic valve disease. The open procedure is particularly beneficial for young, active patients. At 黑料福利社 Langone, we have performed more Ross procedures than almost anywhere else in the nation.

During surgery, surgeons remove the enlarged section of the aortic root and replace it with a synthetic graft, eliminating the aneurysm. They also replace the diseased aortic valve with your own pulmonary valve, which normally handles blood flow from the heart to the lungs. The pulmonary valve is flexible and strong, enabling it to take over the job of the aortic valve. An artificial valve replaces your original pulmonary valve.

Because the Ross Procedure uses your own valve tissue, it often functions more like a natural heart valve. It can also last many years, and does not typically require lifelong use of blood thinners鈥攁s some artificial valves do.

Aortic Arch Endovascular Aneurysm Repair

Aortic arch aneurysms usually require surgery to replace the arch and vessels. Our surgeons may recommend a hybrid procedure. This includes open surgery followed by a stent graft placed with EVAR to seal and strengthen the wall of the aorta, allowing the aneurysm to shrink. We also perform aneurysm repair in patients who previously had this surgery at another institution but who had poor results.

Thoracoabdominal Aneurysm Repair

When a thoracoabdominal aneurysm needs to be repaired or replaced, there is a risk of reduced blood flow to the liver, kidneys, intestines, and spine. Our surgeons have extensive experience in the techniques used to create bypasses that maintain blood flow to these organs and the spine. They may use EVAR to shore up the aorta, while also allowing blood to flow through its connected veins and to vital organs.

Our Research and Education in Aortic Aneurysm

Learn more about our research and professional education opportunities.