Thoracoabdominal Surgery

What is it?

Thoracoabdominal surgery is used to treat an aneurysm of the thoracoabdominal aorta. An aneurysm is an abnormal bulge or enlargement in the wall of a blood vessel and can occur anywhere along the aorta.

Not all aneurysms require immediate surgery. Depending on their size and other individual risk factors, a cardiologist may elect medical monitoring (often called “watchful waiting”). Medical monitoring includes regular visits with your doctor to make sure your aneurysm is not growing and managing other medical conditions that could make your aneurysm worse and increase your risk for an aortic dissection or ruptured aneurysm, which are immediately life-threatening conditions.

When a cardiologist determines that the risk of a ruptured aneurysm or aortic dissection is greater than the risk of the surgery, they will typically recommend a surgical repair.

When an aortic aneurysm occurs in the section of the aorta that runs through the chest and abdomen, it is considered a thoracoabdominal aortic aneurysm. Surgery to repair this type of aneurysm is called thoracoabdominal surgery (or thoracic abdominal surgery). There are two main types of thoracoabdominal surgery – open or traditional surgery and endovascular surgery using a stent graft. These procedures are known as endovascular or transcatheter repair.

Endovascular repair
Endovascular repair of the thoracic aorta is a surgical procedure that does not require surgeons to open your chest to repair the aneurysm.  During this minimally invasive surgery, a cardiologist use a catheter (thin tube) to help place a stent graft (a mesh tube often made of stainless steel) into your aorta. Once the specialist places the catheter, they move it into the malformed portion of your thoracic aorta and place the stent graft. The stent graft is a miniature device that redirects blood flow, avoiding the malformed portion of the aorta (the aneurysm).  The goal of the surgery is to keep the aneurysm from increasing in size.

Typically, the specialist enters the blood vessel through the groin via the femoral artery. If your femoral artery is too small in diameter to accommodate the catheter, this technique may not be an option, and you may require an open surgery. 

Traditional or open surgery
If the femoral artery is too narrow or the location of the thoracoabdominal aneurysm makes endovascular repair too difficult or risky, surgeons may elect to use open surgery to repair the aneurysm.

Depending on the location of the aneurysm, your surgeon may use a full sternotomy (a long incision down the middle of the chest to open the breastbone) or a left thoracotomy (a small incision between the fourth and fifth ribs on your left side).

During open surgery to repair a thoracic abdominal aortic aneurysm, surgeons remove the malformed portion of the aorta and insert a graft (a synthetic tube made of Dacron). Surgeons splice the tube and attach it to the healthy aorta. Eventually, the inner lining of the blood vessels grow over the Dacron tube, which allows blood to flow effectively through it. 

The Loyola difference

Loyola is a nationally recognized leader in cardiac care. U.S. News & World Report ranked us 18th in the nation for cardiology and heart surgery in 2012, making this our 10th year in the top 50.

Learn more about our performance outcomes.