aortic aneurysm surgery

Are you looking for a clinic for an aortic aneurysm operation or information about the surgical procedures? With our specialist and clinic search you can find experienced specialists in clinics and centers. Find out about the causes, operation and risks of an aortic aneurysm. The university hospital of Bonn one of the best university hospital in Germany always consult a healthcare professional for personalized advice and treatment options.

Information on aortic aneurysm surgery

What is an aortic aneurysm?

An aortic aneurysm is a localized bulge in the aorta. The aorta is the main artery in our body. It emerges directly from the left ventricle and initially supplies the arms and head. After this arch, the aorta runs down into the abdominal cavity, branches off to supply the abdominal organs and then divides into the leg vessels. In doing so, it transports large amounts of blood.

Around 80% of all aneurysms affect the aorta. Men are more frequently affected by aneurysms than women. In almost 90% of cases, the aorta is only affected after the renal artery branches off.

Causes of an aortic aneurysm
The causes of an aortic aneurysm can generally be congenital or acquired wall changes. The most common cause of aortic aneurysms is calcification of the arteries (arteriosclerosis). Excess fat is deposited in small cracks in the vessel wall. Over time, this area becomes larger and larger, making the vessel wall brittle and inflexible. This can lead to what is known as an aneurysm dissecans. Blood can penetrate through cracks between the wall layers and cause the vessel wall sac to bulge out. But congenital connective tissue weaknesses can also cause this (e.g. Marfan syndrome).

When is an aortic aneurysm operated on?

Aortic aneurysms often do not cause any symptoms. Around 30-50% of aortic aneurysms are discovered by chance using ultrasound or computer tomography.

If symptoms occur, they are usually pain. For example, a vascular bulge in the abdomen causes back and flank pain, while a vascular bulge in the chest causes chest pain.

The danger of an aortic aneurysm lies in the possibility of a rupture of the vessel wall, which can result in a large loss of blood, which can be fatal if left untreated. The larger the aortic aneurysm, the greater the risk of a rupture of the vessel wall, as more and more pressure is placed on an increasingly fragile vessel wall.

Around 50% of all aneurysms rupture within 10 years. Since emergency surgery cannot save the affected person in many cases, surgery is indicated for aortic aneurysms measuring 5 cm or larger. Aortic aneurysms that are smaller can be observed. Symptomatic aortic aneurysms, however, regardless of size, always require surgery.

How is an aortic aneurysm operated on?

When an aortic aneurysm is surgically treated, the vascular surgery specialist or thoracic surgery specialist replaces the diseased section of the vessel with a vascular prosthesis made of polyester or Teflon. With the inlay technique, the aneurysm sac is opened and the clotted blood is removed. The vascular prosthesis is then sewn in and the vessel is closed again.

An alternative variant is the aortic stent prosthesis. In an interventional procedure (without opening the abdominal cavity), a wire mesh (stent) lined with polyester can be pushed through the femoral artery into the area of the aneurysm. The position is checked using imaging techniques. Once the aortic aneurysm has been reached, the metal wire is released and expands to its normal size.

Some aortic aneurysms in the chest area can also be treated using these methods. However, in the area of the aorta near the heart, open surgery is often necessary. In some cases, a specialist in thoracic surgery, vascular surgery or cardiac surgery must also replace the aortic valve (aortic valve replacement surgery) because the aortic aneurysm has spread to this area.

Prognosis and risks of aortic aneurysm surgery
The prognosis generally depends on the location and size of the aortic aneurysm, but also on the patient's health and age. The mortality rate is around 40% for emergency surgery, 1-5% for normal surgery and 1.4% for stent implantation.

Risks after aortic aneurysm surgery:

During aortic aneurysm surgery, the prosthesis can expand (prosthesis dilatation in up to 20% of cases). This usually happens within the first six months after surgery.
In certain cases, interventional stent prosthesis treatment can lead to further blood flow and thus to growth of the aortic aneurysm (endoleakage).

In addition, the stent can become detached or migrate over time (stent disintegration, stent migration).

This means that in 20% of cases a follow-up operation is necessary. Regular follow-up checks of the prosthesis wearers are therefore absolutely essential in order to detect any changes at an early stage.

If you have any further questions regarding the different types of aortic aneurysm surgery, please contact your treating specialist in vascular surgery or specialist in thoracic surgery.

Which specialists and clinics are specialists for aortic aneurysm surgery?

Anyone who needs aortic aneurysm surgery wants the best medical care for themselves. That is why the patient asks himself, where can I find the best clinic for aortic aneurysm surgery?

As this question cannot be answered objectively and a reputable doctor would never claim that he is the best doctor, one can only rely on the experience of a doctor. The more aortic aneurysms a doctor has operated on, the more experienced he becomes in his specialty.

An aortic aneurysm should only be operated on by experienced specialists in vascular surgery, thoracic surgery, or cardiac surgery. Vascular centers ensure comprehensive diagnostics and treatment of aortic aneurysms at the University Hospital of Bonn.