Aortic aneurysms are abnormal bulges in a weakened part of the aortic artery wall. They may occur anywhere along the aorta:

• Aortic Root Aneurysm: A bulge that occurs at the root – the area of the artery that connects to the heart – distorting the aortic valve and causing leaks
• Ascending Aneurysm: A bulge that occurs between the chest area above the diaphragm and the root
• Abdominal Aortic Aneurysm: A bulge that occurs in the stomach area of the aorta
• Descending Thoracic Aortic Aneurysm: A bulge that occurs in the chest section of the aorta
• Thoracoabdominal Aortic Aneurysm: A bulge that occurs on the aorta midway between the abdomen and chest

Aortic dissection occurs when the wall of the aorta bulges so much that the layers of the aortic wall tear. Usually described as a sudden, sharp, tearing pain in the chest and back, aortic dissections are often mistaken for a heart attack.

Transcatheter Aortic Valve Replacement (TAVR): Also referred to as transcatheter aortic valve implantation (TAVI), is a procedure that replaces your diseased aortic valve with a man-made valve. The TAVR procedure has been recommended to you as an alternative to open heart surgery. The old heart valve is not removed but acts like an anchor for the new heart valve. This procedure is done through small cuts (incisions) using a long, thin tube (catheter), X-rays, and ultrasound.

Thoracic Endovascular Aortic Repair (TEVAR): TEVAR starts with small incisions in the groin. Catheters deliver a stent graft that resembles a fiber mesh tube up through the blood vessels to the aneurysm. The stent lines the aortic wall, allowing a normal flow of blood through the artery. The stent also restricts blood flow to the bulging aneurysm. Deprived of its blood supply, the bulge will ultimately shrink.

The benefits of minimally invasive surgery include:

• Smaller incision, reducing the risk of infection
• Less blood loss
• Less postoperative pain
• Faster healing time
• Shorter hospital stay
• Minimal scarring

Aortic Root Replacement: After removing the section of the aorta that connects it to the heart, including the aortic valve, your surgeon replaces the section with an artificial tube-shaped graft made of fiber mesh and a mechanical or biologic valve.

Valve-Sparing Aortic Root Replacement: If the aortic valve is undamaged by the root aneurysm, the surgeon will only replace the diseased section of the aortic root with a graft, leaving the functional valve in place.

Bentall and Cabrol Procedures: The Bentall procedure replaces the insertion of your aorta into your heart as well as the valve needed to pump blood from your heart into your aorta. The replacement is composed of either an organic material (animal or human) or a mechanical construct. A Cabrol procedure is a similar replacement that adds an artificial conduit to your coronary arteries, which may be necessary in select patients.

Hybrid Aortic Procedures: Hybrid aortic surgery combines traditional open-heart surgery and endovascular stent graft procedures.

Hemi and Full Arch Aortic Aneurysm Repairs: If you have an at-risk section of your aortic arch, such as due to an aneurysm (ballooning and weakening of the aortic wall) or dissection (split within the muscle of the aortic wall, placing it at risk of rupture), it may be necessary to reinforce or repair segments of your aorta. This is often done by removing the damaged segment and placing an artificial graft material, called Dacron. If only a small segment of your aorta is damaged, a small removal and “patch” repair (hemi) can be performed. If too much of your aortic arch is involved, a full replacement may be necessary.