Certain steps to be taken in preparation for abdominal or thoracic aortic aneurysm surgery are:

• If you smoke, you must stop many weeks before the surgery. Smoking increases the risk of infection and slows recovery.
• You will have to go through routine tests like blood tests, ECG, ultrasound of the heart and breathing tests to assess your general health condition.
• The doctor may recommend performing an arteriogram, otherwise called angiogram or angiography, which will help the doctor see how blood moves through the arteries, and to check for a blockage. Also, an aortagram may be done to evaluate the size, shape, structure, and anatomy of the aorta.
• On the day of the operation, you must stop eating or drinking about six hours before the surgery.
• You will be required to sign a consent form. The form confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for the surgery to be performed.
• You may have to wear compression stockings to prevent blood clots in your legs.

As aortic aneurysm surgery carries substantial risks, every effort is made to treat the condition with medication, if it is diagnosed before any emergency develops. If the aneurysm is small and no symptoms are present, your doctor may advise a “watch-and-wait” approach while checking the size of the aneurysm regularly.

Patients may be put on medicines called beta blockers used to treat high blood pressure or coronary artery disease. It has been seen that beta blockers decrease the expansion rate of abdominal aortic aneurysms.

But if the aneurysm is more than 5 cm or is growing at a fast rate, surgery is the only solution.

People with aortic aneurysms – thoracic or abdominal – may need to be operated on an urgent basis. It is for this reason that abdominal and thoracic aortic aneurysm surgery abroad in countries with no wait times like India is sometimes preferred. In many cases it it the high cost that leads people to go abroad for this procedure.

An aortic aneurysm is an abnormal bulge in the aorta wall. The aorta is the largest artery in the human body: it carries oxygenated blood from the heart down through the chest and abdomen, where it divides into a blood vessel that supplies each leg.
An aortic aneurysm can result in a life-threatening situation because it may rupture and cause internal bleeding. The risk of an aneurysm rupturing increases with its size and location.

An aneurysm can form anywhere along the aorta, but is most often formed in the abdominal and the throacic regions. The location of the aneurysm determines the treatment method to be employed.

After surgery, the patient will be in the intensive care unit for a couple of days. Cardiac monitoring is done constantly for blood pressure and heart function. Intravenous fluids and additional medications are given to support cardiac function.

Once the patient can breathe on his/her own, the ventilator is removed. Apart from the ICU stay, the patient may have to stay for about a week in the hospital. At least a month or six weeks are needed to recover from aneurysm surgery.

Patients need to visit their doctor for monitoring once in at least six months.

Aortic aneurysm surgery, be it abdominal or thoracic, is a very complex procedure and is best carried out by a vascular surgeon who has done a significant number of such operations.

The complications that may develop after aortic aneurysm surgery depend on the extent of repair required and on the patient’s general health condition. Even endovascular surgery carries some risks like blood leaking from the graft, known as endoleak. The other risks of aortic aneurysm surgery are:

• Bleeding
• Graft infection
• Heart attack
• Irregular heartbeat
• Kidney damage
• Paralysis
• Stroke
• Sexual dysfunction
• Gangrene of the legs

Abdominal aortic aneurysms are rare in people below 60. About one in 1,000 persons develops an abdominal aortic aneurysm after 60, and this number increases with age. Men are more prone to aortic aneurysms than women. But very few aneurysms are actually large enough to warrant surgery.

Apart from age, there are some factors that increase the risks of developing aortic aneurysms. They are:

• Smoking.
• Caucasians are more susceptible to aortic aneurysms than other groups.
• People with coronary heart disease and peripheral vascular disease may develop aortic aneurysms. (Peripheral vascular surgery is necessitated when there is a narrowing of the blood vessels outside of your heart. Fat and cholesterol build up on the walls of the arteries and block the arteries. This can reduce or stop blood flow, usually to the legs, causing them to hurt or feel numb. Debris or plaque from aneurysms can also cause blocks in the arteries.)
• A family history of aortic aneurysms.
• Marfan syndrome may cause thoracic aortic aneurysms. Marfan syndrome is a genetic condition that affects the connective tissue in the body. People who have it have a weak aortic wall, which may cause aneurysms.

Aortic aneurysms are usually asymptomatic and are discovered during routine check-ups or during chest X-rays or computerized tomography (CT) scan done for some other condition. Some symptoms that may show up because of the aneurysm pressing on nearby organs are intense pain in the chest or back, stroke, cold or numb extremities, or abdominal pain. Sometimes, patients with abdominal aortic aneurysms may notice a pulsating mass in their abdomen.

Abdominal or Thoracic Aortic Aneurysm Surgery in the US, UK, or Canada may be a very expensive surgery, if you do not have insurance. Even if you have insurance, considerable co-pay may be involved, as the cost of the surgery can be $100,000 or more.

But daunting as the cost factor may be, there may be something that’s even more difficult to overcome: the waiting lines in US, UK and Canada. According to studies in the UK, patients with an abdominal aortic aneurysm were waiting too long for surgery.

Hence, both cost of the surgery and time required for your turn to come can determine whether patients with aortic aneurysms live or die, and what their quality of life will be. Medical tourism is nothing short of a blessing in such a condition. Because abdominal or thoracic aortic aneurysm surgery in India is not only extremely affordable, it is also performed without any waiting lines. When you add high quality medical treatment to the above advantages, what you have is an unbeatable combination. No wonder more and more patients are choosing to go abroad for aortic aneurysm surgery. Do not neglect aortic aneurysms, act before it is too late. The condition is definitely treatable, but time is of the essence.

Abdominal aortic aneurysms can be surgically treated in two ways: open chest surgery and endovascular surgery. As the results of endovascular surgery for abdominal aortic aneurysms have been encouraging, similar techniques are being developed for the treatment of thoracic aortic aneurysms too.

In open aortic aneurysm surgery, the weakened portion of the aorta wall is replaced with an artificial graft that will never wear out. The graft is stitched in place with a permanent suture. The location of the aneurysm is very crucial to the operation: it even determines the kind of incision that will be made. If the aneurysm is close to the aortic valve, a median sternotomy may be done and the valve may have to be repaired or replaced.

Endovascular surgery for aortic aneurysm repair results in less blood loss, less trauma, and faster recovery. Endovascular surgery is especially advantageous to those who need surgery but cannot go through an open surgery because of pre-existing medical problems. But everyone doesn’t qualify for this minimally invasive procedure. Your doctor will advise you on which procedure is the best for you.

In endovascular surgery, a synthetic stent-graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm. This graft cuts off the blood supply to the aneurysm and enables blood flow through the stent-graft, avoiding the aneurysm. The aneurysm shrinks over time.

GetVell’s network hospital in India offers repair for thoracic and aortic aneurysm through stenting or surgery. The India vascular surgeon can determine if the patient is suitable for stenting or surgery by looking at the patient’s CT scans and ultrasound.