Thoracic aortic aneurysms cause a bulge in a section of the thoracic aorta and result in a weakening of the main artery that carries blood from the heart to the body. As this bulge increases in size, the risk of rupture and internal bleeding also increases.
Until recently, patients with thoracic aortic aneurysms, pseudo-aneurysms, and injuries to the aorta from trauma, would have needed open surgery for repair -- which included a large chest incision and the temporary clamping of the aorta. Now, experienced vascular surgeons, like those at the University of Maryland Medical Center, can use just one small incision during a minimally invasive procedure to place a high-tech device inside the aorta, relieving the aneurysm from pressure. "The most significant advantage for patients is the faster recovery. They can typically go home from the hospital in a day or two," explains Dr. David Neschis, a vascular surgeon at the UM Medical Center and an assistant professor of surgery at the UM School of Medicine.
By making just a small incision in the groin, vascular surgeons are able to insert a catheter and thread a special device, called the GORE TAG Thoracic Endoprosthesis, towards the aneurysm using high-tech X-ray imaging seen on a monitor. "This device, which is about 15 centimeters long and can be 40 millimeters in diameter, creates a new pathway for blood flow, taking the pressure off the aneurysm," explains Dr. Neschis.
Symptoms of thoracic aortic aneurysms vary. Patients can experience chest, abdominal or neck pain, though some experience no pain. Typically, thoracic aortic aneurysms are diagnosed after a CT or MRI. Surgery is often a treatment option when medical management, like blood pressure medication, has not worked and when the risk of rupture is considerably high.
Dr. Bartley Griffith, chief of Cardiac Surgery at the UM Medical Center and professor and head of the Division of Cardiac Surgery at the UM School of Medicine, adds that the experienced University of Maryland aneurysm team continues to come up with unique and innovative treatment options that will benefit aneurysm patients both now and in the future.
"We've done some original work using a combination of endografts and endografts alone to solve problems -- such as replacing the aortic arch without the use of a heart-lung machine -- that required major operations in the past," explains Dr. Griffith. "We've also done some so-called hybrid procedures, where we mix traditional aneurysm work with the endografts."