The aorta is the artery carrying oxygen-rich blood from the heart to every organ in the body. The aorta begins within the heart, travels upward, bends over, and runs along the spine. It then passes the diaphragm into the abdomen before splitting into branches that supply blood to legs and pelvis. The aorta is significant as if it were the main water pipe. It delivers oxygenated blood to important organs such as heart, brain, spinal cord, limbs, and abdominal organs including liver, kidney and colon. Consequently, aortic abnormalities can affect different parts of the body and if the aorta bursts, it can eventually lead to death.
Many patients do not have any symptoms and aneurysm can incidentally be detected from chest x-ray or a pulsing mass in the stomach. However, patients with thoracic aortic aneurysm may have symptoms due to the pressing against nearby organs whether difficulty breathing from the pressure on trachea, difficulty swallowing from pressure on esophagus or hoarseness from the compression of laryngeal nerve. In addition, chest or back pain, loss of consciousness, or coughing up blood can also be a sign of aortic dissection and rupture.
Aortic Aneurysm is often found in the elderly or in people who have genetic disorder such as Marfan’s (an abnormality in many parts of the body, People with Marfan’s tend to be tall and thin with long arms, legs, fingers, a high-arched palate, eye problem, and leaky heart valve). Blood vessel problem appears since younger age.
Smoking, hypertension, and chronic lung diseases all are the risk factor of aortic aneurysm.
New Alternatve Treatment
Endovascular Aortic Aneurysm Repair (EVAR) for an abdominal aortic aneurysm (AAA) and Thoracic Aortic Aneurysm Repair (TEVAR) for thoracic aneurysm repair become a new effective treatment option. Using X-ray images for guidance, a stent-graft is inserted through the femoral artery up to the aorta where the aneurysm is located. The stent graft is then expanded in the aneurysmal area and fastened in place to form a stable channel for blood flow, preventing the aneurysm from rupturing. The advantage of this technique is that it involves only a small cut; therefore, it is less invasive, less pain and less blood loss, faster recovery time and fewer complications than open surgery. However, endovascular surgery also required other factors such as knowledge and experience of surgeon, standard operating room that is designed for complicated case of surgery.
Hybrid Operating Room is appropriate for patients requiring catheter-based intervention and for patients having the high risk of revision surgery when complications or errors happen, for performing endovascular procedures resulting in fewer complications. It is also suitable for Trancatheter Aortic Valve Implantation (TAVI) which can be done without opening heart, especially for patients who have higher risk in the major surgery and some treatments that need to be done collaboratively for optimum effectiveness such as Cardiac Electrophysiology.