Minimally Invasive Aortic Aneurysm & Dissection Surgery

What is an aortic aneurysm?

The aorta is the largest artery, carrying blood from the heart to the rest of the body. When part of its wall weakens and bulges to well beyond its normal diameter, it is called an aortic aneurysm. Aneurysms are classified as thoracic or abdominal depending on location. Most cause few or no symptoms before they grow large or rupture, and are often found incidentally during a health check or imaging for another reason.

What is aortic dissection?

In aortic dissection, the inner layer of the aorta tears and blood forces its way between the layers of the vessel wall, creating a "false channel." It is a medical emergency, typically presenting as sudden, severe, tearing chest or back pain. Urgency depends on whether the ascending aorta (the segment closest to the heart) is involved: those cases usually require emergency surgery, while others are assessed by the care team according to the patient's condition.

Who is at higher risk?

• Long-standing or poorly controlled high blood pressure
• Smoking
• Older age, with somewhat higher risk in men
• Atherosclerosis and high cholesterol
• Family history of aortic aneurysm or dissection
• Certain inherited connective tissue disorders (such as Marfan syndrome)

Treatment options

Monitoring and risk-factor control

Smaller, slow-growing aneurysms are usually monitored with regular imaging, together with strict blood pressure control and smoking cessation to reduce the risk of progression.

Aortic stent graft (endovascular repair)

Through a small incision in the groin, a catheter is guided under imaging to place a stent graft at the diseased segment, reinforcing the vessel from the inside and sealing off the aneurysm or tear. Compared with open surgery, the incision is smaller and recovery is usually faster, but suitable vessel anatomy is required and regular imaging follow-up is needed afterward.

Open surgical graft replacement

When the location or shape is not suitable for a stent graft, open chest or abdominal surgery may be needed to replace the diseased segment with a synthetic graft.

The most suitable approach depends on the aneurysm's size, location, growth rate, symptoms, and overall health, and is discussed after clinical and imaging evaluation.

When to seek care

• Sudden severe chest, back, or abdominal pain: go to the emergency department immediately
• A report mentions "aortic dilatation" or "aortic aneurysm": book a cardiovascular surgery evaluation
• Higher-risk groups (for example, older men with a long smoking history or a family history): ask whether screening is appropriate