During open aneurysm repair, your surgeon makes an incision in your chest and replaces the weakened portion of your aorta with a fabric tube, called a graft. The graft is stronger than the weakened aorta and allows blood to pass through it without causing a bulge. Many patients who have a thoracic aortic aneurysm also have heart disease or involvement of the aorta adjacent to the heart. For extensive or complex thoracic aneurysms, sometimes heart surgery is required at the same time as open aneurysm repair depending upon the situation.
The operation, including the incision that is made, depends on the location of the aneurysm. If the aneurysm is close to the aortic valve, an incision in the front of the chest such as a median sternotomy may be used. If the aneurysm is close to the valve, the aortic valve may have to be repaired or replaced. Surgery on the aortic arch is usually done from the front as well. If the aneurysm involves the descending thoracic aorta, which lies in the left chest, or the thoracic abdominal aorta, an incision on the left side of the chest will likely be required. If the aneurysm is confined to the abdomen, then an incision either in the abdomen, or on the side or flank may be used.
Following the surgery, you may stay in the hospital for five to 10 days. If your aneurysm is extensive or complex, or if you have other conditions such as heart, lung or kidney disease, you may require two to three months for a complete recovery.