Aortic Aneurysm Repair (Descending Aorta)

An aortic aneurysm is a bulge swelling in the aorta—the body’s largest blood vessel. The aorta feeds blood from the heart to tissues and organs in the body. The part of the aorta that travels through the left chest and passes into the diaphragm is called the descending thoracic aorta. The larger an aneurysm grows, the more likely it is to rupture or burst, which is life-threatening. 

The most common cause of an aneurysm in the descending thoracic aorta is a weakening in the artery wall caused by a hardening of the arteries (atherosclerosis). Risk factors for this type of aneurysm include:

  • Family history
  • High blood pressure
  • High cholesterol
  • Infection
  • Previous strokes
  • Smoking

If an aneurysm in the descending thoracic aorta is small and causes no symptoms, your doctor may suggest:

  • Blood pressure medication
  • Increasing aerobic exercise
  • Limiting heavy lifting
  • Stopping smoking
  • Watchful waiting (monitoring the size of the aneurysm with computerized tomography or CT scans)

If the aneurysm is large or grows quickly, or if you have symptoms such as intense pain in the chest, back or jaw, your vascular doctor may suggest surgical repair to prevent the artery from bursting and causing life-threatening internal bleeding.  

What is a descending aortic aneurysm repair?

Surgical repair of an aneurysm in the descending aorta is done by a vascular surgeon who has experience with this type of surgery. The repair can include either endovascular surgery or open surgery. During either of these procedures, we use general anesthesia, which allows you to be asleep for the surgery. Your doctor will suggest the right procedure for you based on your condition, age and overall health. 

Endovascular surgery

Endovascular surgery involves inserting a sleeve or liner inside the aortic aneurysm. Your surgeon makes a small cut in your leg, inserts the lining inside the aorta and moves it to the aneurysm to take the pressure off the vessel wall, preventing it from swelling or leaking. This minimally invasive procedure allows you to recover more quickly and easily than with open surgery.

Open surgery

Open surgery involves replacing the diseased part of the artery with an artificial blood vessel (graft). To do this, your surgeon makes a cut—usually along the left side of your chest—and spreads the ribs, then replaces the weakened area of the aorta with an artificial graft made of cloth. Blood flow through the aorta must be stopped temporarily while your surgeon sews the graft in place. Often, blood circulation to the body is maintained using mechanical pumps while the aorta is clamped.

What to expect

Depending on your surgery type, you can expect the operation to last several hours.

Recovery after descending aortic aneurysm repair

Afterward, you will recover in the hospital for about 3 to 7 days. Hospital time is less after endovascular surgery than after open surgery. Most patients gradually increase physical activity and eventually return to work and normal activities in 4 to 8 weeks. Your recovery time and experience will depend on the type of surgery you have, your condition and your overall health.