Aortic interventions encompass a range of medical procedures designed to address various conditions affecting the aorta, the main artery that carries oxygen-rich blood from the heart to the rest of the body. These interventions involve minimally invasive techniques to repair aneurysms, dissections, and other abnormalities in the aorta. By restoring proper blood flow and preventing potential complications, aortic interventions play a vital role in preserving cardiovascular health and enhancing patients' quality of life.
When evaluating patients for aortic interventions, a thorough assessment is carried out. This assessment considers vital factors like aorta anatomy, aneurysm size and characteristics, the patient’s overall health, and their readiness for anesthesia. Based on this evaluation, a patient-focused approach is adopted, involving a team of multidisciplinary experts who collaborate to analyze data and establish the most suitable treatment plan.
Patients with complex medical histories or multiple comorbidities, who are at heightened risk, receive special attention in the development of a tailored treatment plan that takes their specific vulnerabilities into account. Through this personalized approach, the medical team aims to mitigate potential risks, improve outcomes, and deliver the highest standard of care to each patient.
There are two main types of aortic interventions: Thoracic Endovascular Aortic Repair (TEVAR) and Endovascular Aortic Repair (EVAR). These procedures are minimally invasive alternatives to open-heart surgery and are used to treat aneurysms as well as other aortic pathologies:
TEVAR is performed to treat conditions affecting the thoracic (upper) portion of the aorta, such as thoracic aortic aneurysms and dissections. The procedure involves the following steps:
Small incisions are made in the groin area to access the femoral arteries, or directly in the chest.
Guidewires and catheters are threaded through the arteries and advanced to the aortic site that requires repair.
A stent graft (a fabric-covered metal mesh) is inserted through the catheter and positioned within the aorta to reinforce the weakened or damaged section.
The stent graft is deployed, anchoring itself against the healthy aortic tissue to exclude the aneurysmal or diseased segment from blood circulation.
X-rays or fluoroscopy are used to ensure proper stent graft placement and blood flow.
EVAR is used to treat abdominal aortic aneurysms by deploying a stent graft within the abdominal portion of the aorta. The procedure is similar to TEVAR but is applied to the lower part of the aorta:
Small incisions are made in the groin area to access the femoral arteries.
Guidewires and catheters are threaded through the arteries and advanced to the aortic site that requires repair.
The stent graft, a fabric-covered metal mesh tube, is inserted through the catheter and positioned within the aneurysm.
The stent graft is carefully deployed, conforming to the shape of the aorta. The stent graft effectively lines the inside of the aorta diverting blood flow away from the aneurysm, reducing the risk of rupture.
The stent graft includes sealing mechanisms to ensure it adheres to the healthy portion of the aorta and prevents blood leakage. Small hooks or anchors help secure the stent graft in place.
The post-care of these interventions usually encompass the following measures:
Periodic CT scans or ultrasounds are performed to monitor the stent graft's effectiveness and detect any potential complications.
Patients are encouraged to make lifestyle changes to promote overall health, such as quitting smoking, managing blood pressure, and adopting a heart-healthy diet.
Advancements in technology, imaging, and minimally invasive techniques will continue to shape aortic interventions. Customised stent grafts, robotic-assisted procedures, and enhanced patient outcomes are on the horizon.
Atrius offers cutting-edge expertise in aortic interventions, backed by a multidisciplinary team of doctors, advanced imaging, and state-of-the-art facilities. Patient-centred care, innovative techniques, and a track record of success make Atrius a top choice for comprehensive aortic treatments.