Surgery for Aortic Aneurysm and Aortic Dissection

The aorta is the large artery that leaves the heart and provides oxygen-rich blood throughout the body.

Many diseases and conditions can cause the aorta to dilate (widen) or can cause aortic dissection (tear) increasing your risk for future life-threatening events. These conditions that can lead to aortic aneurysm and aortic dissection include:

  • atherosclerosis (hardening of the arteries)
  • hypertension (high blood pressure)
  • genetic conditions (such as Marfan Syndrome)
  • connective tissue disorders (such as Ehler-Danlos disorder, polychondritis, scleroderma, osteogenesis imperfecta, polycystic kidney disease, and Turners Syndrome)
  • injury

What is aortic dissection and what causes it?

An aortic dissection is usually caused by high blood pressure. Aortic dissection is a condition that forces the layers of the wall of the aorta apart through increased blood flow. Over time, the pressure of the blood flow can cause the weakened area of the aorta to bulge like a balloon, stretching the aorta, causing aortic dissection and leading to severe, sharp, tearing pain in your chest and back.

When is surgery needed to treat aortic disease?

Surgery is needed to treat aortic disease for various reasons. A primary cause for surgery is when an artery wall in the aorta weakens and the wall abnormally expands or bulges as blood is pumped through it. This bulging is called an aortic aneurysm, and can lead to aortic dissection. An aneurysm can develop anywhere along the aorta:

  • Aneurysms that occur in the section of the aorta that runs through the abdomen (abdominal aorta) are called abdominal aortic aneurysms.
  • Aortic aneurysms that occur in the chest area are called thoracic aortic aneurysms and can involve the aortic root, ascending aorta, aortic arch or descending aorta.
  • Aneurysms that involve the aorta as it flows through both the abdomen and chest are called thoracoabdominal aortic aneurysms.

Is an aortic aneurysm serious?

Aortic aneurysms are the 13th leading cause of death in the United States. Research has shown that patients with large thoracic aneurysms are more likely to die of complications associated with their aneurysms than from any other cause.

What types of surgery are used to treat aortic disease?

A variety of complex aortic surgery procedures are performed at Cleveland Clinic. Ascending aorta, aortic arch, descending aorta, thoracoabdominal repairs and thoracic aorta endovascular stent graft procedures are all performed by a multidisciplinary team.

During the last ten years, 21% of open great vessel procedures performed at Cleveland Clinic were for life-threatening acute aortic dissections.

What complex aortic procedures are used at Cleveland Clinic?

Cleveland Clinic surgeons have considerable experience and expertise in performing complex aortic operations, with just under 1,000 aorta procedures performed in 2008.

Innovations advancing complex aortic surgery

For decades, Cleveland Clinic has been a world leader in medical breakthroughs and innovations. For example, two of the most important advances in modern cardiac care occurred at Cleveland Clinic. The first major contribution was the invention of coronary angiography in 1958. The next milestone was the first coronary artery bypass operation.

  • Developed and refined at Cleveland Clinic beginning in 1967, coronary artery bypass has become the most common heart surgery in the world.
  • Continued advances at Cleveland Clinic are enhancing complex aortic surgery, as well.