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Aortic Surgery

Aortic Surgery

Expert surgical management of diseases affecting the aorta

Overview

Aortic surgery encompasses procedures to treat diseases affecting the aorta — the largest artery in the body, responsible for carrying oxygen-rich blood from the heart to the rest of the body. Aortic diseases can be life-threatening if left untreated and require specialized surgical expertise.

Conditions of the aorta include aneurysms (abnormal dilation), dissections (tears in the vessel wall), and other structural abnormalities affecting the ascending aorta, aortic arch, or descending aorta.

Dr. Nisarga has extensive experience in managing complex aortic pathology, employing a range of surgical techniques from conventional open repair to hybrid and endovascular approaches.

Key Facts

7–14 days

Typical Hospital Stay

Lifelong

Graft Durability

Emergency

Dissection Requires Urgent Surgery

Excellent

Elective Repair Outcomes

Conditions Treated

Aortic Surgery is used to treat the following conditions

Ascending Aortic Aneurysm

Dilation of the aorta as it leaves the heart, at risk of rupture

Aortic Dissection

A tear in the inner layer of the aortic wall (Type A or Type B)

Aortic Root Aneurysm

Enlargement of the aortic root, often associated with connective tissue disorders

Aortic Arch Aneurysm

Aneurysm involving the curved portion of the aorta

Thoracoabdominal Aortic Aneurysm

Extensive aneurysm involving both chest and abdominal aorta

Aortic Coarctation

Congenital narrowing of the aorta

Traumatic Aortic Injury

Aortic damage from high-impact trauma

Symptoms

Patients with conditions requiring Aortic Surgery may experience one or more of the following symptoms. It is important to note that some conditions may be asymptomatic in their early stages.

Severe chest or back pain (often described as tearing or ripping in dissection)
Shortness of breath
Hoarseness or difficulty swallowing (from compression)
Cough or wheezing
Pain between the shoulder blades
Difference in blood pressure between arms
Symptoms of heart failure if aortic valve is involved
Often asymptomatic — detected incidentally on imaging

Important: These symptoms can also be caused by other medical conditions. If you experience any of these symptoms, please consult a qualified healthcare professional for an accurate diagnosis.

Diagnosis

A thorough diagnostic evaluation is essential for accurate diagnosis and treatment planning

CT angiography — the primary imaging modality for aortic diseases
Echocardiography (transthoracic and transesophageal)
Magnetic resonance angiography (MRA)
Chest X-ray (may show widened mediastinum)
Aortography for detailed anatomical assessment
Genetic testing for connective tissue disorders (Marfan, Ehlers-Danlos, etc.)
Regular surveillance imaging for known aortic aneurysms

Treatment Options

The choice of treatment depends on the specific condition, its severity, and individual patient factors

Medical Management

Blood pressure control and regular imaging surveillance for small aneurysms

Open Surgical Repair

Replacement of the diseased aortic segment with a synthetic graft

Valve-Sparing Aortic Root Replacement

Replacement of the aortic root while preserving the patient's own aortic valve

Bentall Procedure

Combined replacement of the aortic valve, root, and ascending aorta

Hybrid Arch Repair

Combined surgical and endovascular approach for arch aneurysms

Endovascular Aortic Repair

Stent-graft repair for select descending aortic pathologies

Surgical Approach

How the procedure is performed by Dr. Nisarga and his team

1

The specific surgical approach depends on the location and extent of aortic disease.

2

For ascending aortic aneurysms: A median sternotomy is performed, and the diseased aortic segment is replaced with a synthetic Dacron graft.

3

For aortic root involvement: A composite graft replacement (Bentall procedure) or valve-sparing root replacement (David procedure) is performed.

4

For aortic dissection (Type A): Emergency surgery is performed to replace the ascending aorta and repair the entry tear.

5

Deep hypothermic circulatory arrest may be used for complex arch repairs to protect the brain during the procedure.

6

Intraoperative transesophageal echocardiography and neuromonitoring are used to guide the procedure and ensure optimal outcomes.

Benefits

Why patients and physicians choose Aortic Surgery

Lifesaving treatment for acute aortic dissection and large aneurysms
Definitive repair preventing rupture — which has high mortality
Valve-sparing techniques avoid the need for lifelong blood thinners
Excellent long-term durability of surgical grafts — typically lifelong
Improved quality of life by alleviating symptoms and anxiety
Low operative mortality in elective repairs at experienced centres

Recovery & Rehabilitation

What to expect during the recovery period after Aortic Surgery

ICU stay of 2–5 days depending on the complexity of the repair.
Total hospital stay typically 7–14 days for major aortic surgery.
Recovery is more prolonged than standard cardiac surgery due to the complexity.
Strict blood pressure control is essential during recovery and long-term.
Regular imaging surveillance (CT or MRI) is required to monitor the remaining aorta.
Return to normal activities typically takes 8–12 weeks.
Lifelong follow-up with a cardiologist specializing in aortic disease is recommended.

A Word from Dr. Nisarga

Due to the complexity and extent of aortic diseases, minimally invasive approaches have limited application. However, for select distal arch or descending aortic pathologies, hybrid approaches combining open and endovascular techniques may reduce surgical trauma. Dr. Nisarga evaluates each patient individually to determine the safest and most effective approach.

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