An Abdominal or Thoracic Aortic Aneurysm Surgery is done when a weakness in the artery wall of the aorta causes the aortic wall to abnormally expand or bulges as blood is pumped through it. This swelling or dilatation is called an aortic aneurysm.
An aneurysm can develop anywhere along the aorta:

• Abdominal aortic aneurysms occur in the section of the aorta that runs through the abdomen
• Aneurysms that occur in the chest area are called thoracic aortic aneurysms and may involve the ascending aorta, aortic root, aortic arch or the descending aorta
• Thoraco-abdominal aortic aneurysms involve the aorta as it flows thru both the abdomen and chest

A thoracic aortic aneurysm if ruptured or torn can cause life-threatening internal bleeding. A thoracic aortic aneurysm can more often be repaired with surgery or other less invasive techniques.

Small aneurysms place one at increased risk for:

• Atherosclerotic plaque (fat and calcium deposits) formation at the site of the aneurysm
• A clot (thrombus) may form at the site and dislodge, increasing the chance of strokeIncrease in the aneurysm size, causing it to press on other organs, causing pain
• Aortic dissection or tearing of the layers of the aorta, a potentially fatal complication and a medical emergency
• Aneurysm rupture, because the artery wall thins at this spot, it is fragile and may burst under stress. A sudden rupture of an aortic aneurysm may be life threatening and is a medical emergency

Causes:

Hardening of the arteries as one ages, known as atherosclerosis, is the most common cause for a thoracic aortic aneurysms. When atherosclerosis occurs, a sticky substance called plaque builds up in the walls of the arteries. Over time, excess plaque causes the aorta to stiffen and weaken.

The risk for atherosclerosis increases with any of the following situations with the patient

• Smoking
• High blood pressure
• Being overweight
• High cholesterol levels
• Family history of cardiovascular or peripheral vascular disease

The following diseases can also weaken the aortic wall and thus increase the risk of thoracic aortic aneurysms

• Marfan syndrome
• Tuberculosis
• Presence of a bicuspid aortic valve
• Syphilis
• Other non-specific connective tissue disorders (characterized by a family history of aneurysms)

Symptoms :

Patients rarely feel any symptoms and hence Thoracic aortic aneurysms often go unnoticed because. Possible warning signs include:

• Pain in the jaw, neck and upper back
• Chest or back pain
• Coughing, hoarseness, or breathing difficulty

Aortic dissection occurs when the layers of the aorta tear and separate from each other. Aortic dissection can occur suddenly, causing severe sharp, tearing pain in your chest or Abdominal or Thoracic Aortic Aneurysm Surgeryupper back. Since it is commonly associated with high blood pressure, an aortic dissection forces the layers of the wall of the aorta apart through increased blood flow. If not treated early, aortic dissection weakens the aorta and can lead to a thoracic aortic aneurysm by causing the weakened area of the aorta to bulge like a balloon, stretching the aorta.

Diagnosis:

Early diagnosis of a thoracic aneurysm is very important to managing the condition. The risk of rupture increases with size and rate of growth. Neglecting the aneurysm presents a higher risk and could be life threatening.
The following tests helps in the diagnosis:

• Magnetic resonance imaging (MRI)
• X-Ray of the Chest
• Computed tomography (CT) scan
• Echocardiography
• Abdominal ultrasound
• Angiography

Treatment:

If the aortic aneurysm is small in size and not causing any symptoms, observation in periodic intervals may be recommend by the physician. It may be watched with CT or MRI scans every 6-12 months, the aneurysm will be watched for signs of changes. Blood pressure and cholestrol lowering medication would be prescribed by the doctor if any of these are required.
Surgical Repair
If the thoracic aortic aneurysm is large, prompt treatment would be advised to prevent a rupture from occurring. The weakened section of the vessel is surgically removed and replaced with a graft of artificial material. If the aneurysm is close to the aortic valve a valve replacement may also be recommended during the procedure.
Endovascular Repair
Endovascular aneurysm repair (EVAR, TEVAR, TA-EVAR) is performed inside the aorta using thin, long tubes called catheters. The catheters are used to guide and deliver a Stent-graft through the blood vessels. The Stent graft is then positioned in the diseased segment of aorta like a sleeve to divert blood flow away from the aneurysm. This approach is used to treat abdominal and descending thoracic aneurysms, and is being evaluated as a treatment for Thoraco-abdominal and Arch aneurysms.
Repairing a thoracic aneurysm in most cases require open-chest surgery. The patient will be under general anesthesia.
Hospital stay of would typically be for about 8 days.

The other major Cardiac Procedures are:

• Angioplasty
• Heart Valve Replacement
• VSD (Ventricular Septal Defect Closures) Closures
• CABG ...etc

Few Major Hospitals for the Treatment of Abdominal or Thoracic Aneurysm Surgery are:

• Narayana Hrudayalaya
• Wockhardt Hospitals
• Asian Heart Institute
• Bangkok Hospital Medical Center
• Florence Nightingale Hospital

Thailand, Malaysia, Singapore, Turkey and India are the most cost effective locations that offer up to almost 80% savings in comparison to the US.

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