Aortic Aneurysm

Treatment

Once an aneurysm forms, it will not disappear on its own. Medication may help slow its growth, but is not a cure. Most aneurysms eventually need repair.

Mayo Clinic surgeons repair more than 600 aortic aneurysms each year. Mayo Clinic is one of the largest centers in the world for aortic aneurysm surgery, with highly trained and experienced specialists who team to provide the most appropriate treatment for patients.

Monitoring

If the aneurysm is small and there are no symptoms (for example, if the aneurysm is found during a routine physical examination or discovered in tests for another condition), a physician may recommend watching and waiting. An ultrasound or echocardiogram, CT scan, or MRI once or twice each year is a common monitoring strategy.

Medication

If the aneurysm is small, medication may be recommended to prevent enlargement or complications. Anti-hypertensives such as beta-blockers may be used to lower blood pressure.

Surgery

Surgery becomes an option when an aneurysm enlarges enough that the danger of rupture exceeds the risk to the patient from surgery.

Two surgical options are available at Mayo Clinic to repair aortic aneurysms: endovascular and open surgery. Mayo Clinic surgeons perform both techniques frequently.

Endovascular Surgery

Whenever feasible, physicians at Mayo Clinic prefer to use less-invasive endovascular surgery to repair thoracic and abdominal aortic aneurysms.

Open Surgery Graft

Enlarge

Open Abdominal or Open Chest Surgery

In open surgery, the skin and tissue are cut to allow direct access to the aorta and the aneurysm.

A standard surgical treatment for aortic aneurysm is replacement of the damaged portion of the aorta with an artificial graft, typically made from Dacron®. The graft is sewn in place with permanent sutures. The operation, including the incision, depends on the location of the aneurysm.

• If the aneurysm is confined to the abdomen, an incision may be made either in the abdomen or on the side or flank.
• If the aneurysm is in the chest close to the aortic valve, an incision in the front of the chest may be used.
• Surgery on the aortic arch is usually done from the front.
• If the aneurysm involves the descending thoracic aorta, which lies in the left chest, or the thoracic and abdominal aorta, an incision on the left side of the chest will likely be required.
• If the aneurysm is in the aortic root (where the aorta emerges from the heart) and involves the valve, the aortic valve may have to be repaired or replaced. Mayo Clinic's cardiac surgeons are experienced at valve-preserving (or valve-sparing) aortic root repair.

The length of the operation and the risks involved depend on the extent of the repair and the patient's general health. Recovery time varies, but most people need at least four to six weeks. The length of the hospital stay depends on the patient's condition and the operation performed. A typical stay is one week.

Ruptured aortic aneurysms may be repaired with emergency surgery, but the outcome generally is less successful than if an aneurysm is detected and treated before it ruptures. Many people who experience a ruptured aortic aneurysm die before they reach the hospital.