At Memorial Hermann Health System, we are committed to caring for a full range of cardiovascular conditions. Our affiliated physicians are nationally recognized and utilize leading-edge technology to offer a variety of treatment options. We have extensive experience with both minimally invasive surgery and traditional open-surgery techniques, and can tailor treatment to each patient’s specific health needs.
Endovascular aortic repair is one of the many minimally invasive procedures we perform. Treatment is essential for patients with aortic aneurysm, and our affiliated physicians can determine which level of care is most appropriate.
Thoracic endovascular aortic repair (TEVAR) is a minimally invasive surgical procedure to treat aortic aneurysm, dissection, or injury.
The aorta is the largest artery in the body. Its job is to carry blood from your heart to the other organs and systems. When an area of the aorta weakens, it can cause a bulge known as an aortic aneurysm. This is a serious condition, because an enlarged aortic aneurysm can rupture (burst) which may lead to death.
The TEVAR procedure reinforces the weakened portion of the aorta to reduce the risk of rupture. With this minimally invasive procedure, a small incision in the groin the size of a dime is made and a stent-graft is inserted into the diseased portion of the aorta via catheters. The stent-graft will remain in place to strengthen and support the aorta.
Treatment will depend on the size of the aortic aneurysm and whether or not it is growing. Usually, TEVAR is appropriate for aneurysms that are at least 5-6 centimeters in size.
Your doctor may conduct imaging tests to determine if TEVAR is the best option for your aortic aneurysm. This could include a computerized tomography (CT) scan, magnetic resonance imaging (MRI) or transesophageal echocardiogram (TEE).
If the aneurysm is small, your doctor may recommend medication and consistent monitoring of the condition instead of surgery.
Because TEVAR is a minimally invasive procedure, it usually has a quicker recovery and a lower risk of complications than traditional open-heart surgery. Most patients are able to leave the hospital sooner and get back to their everyday activities more quickly.
You will receive general anesthesia so that you do not feel any pain during surgery or remember anything from your surgery.
Once you are asleep, the surgeon will make a small incision in your groin and insert a thin tube (catheter) into a blood vessel. A small metal device called a stent will be attached to the end of the catheter.
X-ray technology will allow your surgeon to accurately guide the catheter (with the stent attached) through an artery until it reaches the aortic aneurysm. Then, the stent is expanded which will securely fasten it into place in the aorta.
The aorta will be reinforced and stronger with the stent in place, and blood will be routed around the aneurysm and will flow through the device instead. The aneurysm may get smaller over time.
Once the stent is in place, your surgeon will remove the catheter and close the incision.
TEVAR usually has fewer risks than traditional open surgery but, like any procedure, there are still risks and side effects that can occur. Some possible complications may include:
Before surgery, your physician may prescribe medication to assist in lowering blood pressure and relaxing blood vessels. If you take blood thinners, you may be advised to discontinue them before the procedure.
You will need to stop smoking before your surgery to increase the likelihood that the surgery will be successful and you will have a smooth recovery.
Talk with your physician for any other special preparations you need, based on your specific health condition.
When your TEVAR surgery is complete, you will most likely stay in the hospital for a few days.
Once you return home, you will need to avoid strenuous activity for a few weeks, or as advised by your physician. While TEVAR has a faster recovery than traditional open surgery, be sure to talk with your physician about when it is safe to resume daily activities.
Minimally invasive surgery is a beneficial alternative to open surgical techniques. If you have an aortic aneurysm, the TEVAR procedure may be a good option.
The affiliated physicians at Memorial Hermann Heart & Vascular Institutes can evaluate your condition and recommend a treatment plan to meet your specific health needs, so you can get back to the life you enjoy.
To learn more about TEVAR, visit Find a Doctor to schedule an appointment.
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