Aortic Arch Surgery

About This Procedure

Aortic arch aneurysm is an abnormal dilation of the most superior part of the aorta that gives rise to the arteries supplying blood to the upper body, including the brain and the arms. Aortic aneurysms predispose patients to a risk of aortic dissection (tear in the wall of the aorta), bleeding or rupture. Aortic arch replacement is recommended for large aneurysms to minimize the risk of these complications.

Aortic arch surgery requires complex circulatory management and hypothermic circulatory arrest, where the body is cooled to very low temperatures while maintaining selective blood perfusion to preserve blood supply to the brain. This involves supplying oxygen-rich blood to the brain using a process called selective antegrade cerebral perfusion. This strategy preserves vital organs while Massachusetts General Hospital cardiac surgeons work to replace the aneurysmal portion of the aortic arch. For aneurysms that involve the proximal descending aorta, hybrid techniques such as the “Frozen Elephant Trunk” procedure can be performed. This involves placement of a stent graft in the proximal descending aorta during circulatory arrest to accomplish single stage treatment of these aneurysms.

Referrals

Patient referrals can be made to the Thoracic Aortic Center at 617-724-4747 or directly to any of the participating physicians. Coverage is available 24 hours per day, seven days per week to receive emergency referrals from any regional physician or emergency department if an acute syndrome related to the thoracic aorta is suspected. A phone call to the Thoracic Aortic Center will set in motion the assembly of a team for emergency evaluation and management of the patient.

Outpatient referrals of patients with thoracic aortic aneurysms will result in multidisciplinary evaluation by appropriate physicians from cardiology, vascular radiology, cardiac and vascular surgery. Patients can be seen by multiple physicians on the same day, and the appointments are made with a single phone call to the Thoracic Aortic Center number.

Evaluation will result in a recommendation for either intervention or follow-up. Follow up for the aortic problem will be arranged at the center. General cardiac and pulmonary evaluation may also be done.