If the aneurysm is close to the aortic valve, or an ascending aortic aneurysm (located in the part of the aorta that exits the heart then travels up toward the neck), the valve may also have to be repaired or replaced through an incision on the front of the chest wall. This incision is called a median sternotomy and extends down the front of the chest, through the breastbone or sternum, which enables the cardiothoracic surgeon to see the heart and aorta.
Surgery on the aortic arch (the curve in the aorta after it leaves the heart and travels up toward the neck, then down into the chest toward the abdomen) is also usually done from an incision on the front of the chest wall. If the aneurysm involves the descending thoracic aorta (the part of the aorta after the curve in the neck which travels down toward the abdomen), an incision on the left side of the ribcage may be required.
This content originally appeared online in "The Patient Guide to Heart, Lung, and Esophageal Surgery" from the Society of Thoracic Surgery.
An aortic aneurysm is dilation, bulging or ballooning of a weakened part of the aortic artery wall. The normal pressure of blood from the pumping of the heart causes the weakened portion of the aorta to slowly stretch and bulge, leading to the formation of an aneurysm. The key to successful treatment of thoracic aortic aneurysm is careful monitoring and referral for surgical consultation to avoid rupture of the aneurysm, a medical emergency requiring immediate surgical intervention. Experts agree that aneurysms of greater than 5.5 cm in diameter should be evaluated for surgical repair because the risk of rupture increases with increasing size of the aneurysm.
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