Thoracic aortic surgery

The cardiac surgery clinic of Mediterraneo Hospital provides the whole range of surgical treatment of ailing thoracic aorta. This includes the treatment of selected patients with aortic aneurysms and chronic dissections, emergency treatment of patients with acute aortic dissection or aortic injury, dangerous for life.

Range of treatment – Aortic surgery

  • Replacement of ascending aorta with a composite tubular valve-graft and re – implantation of coronary vessels.

  • Replacement of ascending aorta using David procedure, with preservation of the aortic valve.

  • Insertion of “elephant trunk” prosthesis into descending thoracic aorta.

  • Partial or complete replacement of aortic arch.

  • Supracoronal replacement of the ascending and descending aorta and the aortic arch with hybrid implant.

Surgery of aortic root is an important therapeutic sector of our clinic. Apart from the accomplishment of all the standard replacement techniques concerning the aortic root, including the D. Ross procedure, the reconstructive techniques are especially established, with preservation of the aortic valve (T. David procedure). Because of the possibility to avoid the administration of anticoagulants, this method is particularly used in patients with Marfan’s syndrome, while it is used more and more often in patients with acute dissection of thoracic aorta. The above-mentioned techniques are particularly recommended to young female patients who wish to get pregnant.

The development of new surgical techniques improves the surgical results, aiming to the improvement of the patient’s post-operative life quality. New implants (the so-called hybrid implants), which are connected with a conventional vascular implant, are used for the replacement of the ascending aorta, aortic arch and the descending aorta. By this way, an additional surgical intervention can be avoided for many patients.

The hybrid implant consists of a related stent part and a classical part of tissue implant. In case of an aneurysm that affects either the aortic arch or the descending aorta, the descending aorta is replaced by the stent and the aortic arch (if needed, the ascending aorta too) by the part of tissue of the implant. In this part, the vessels that supply blood and oxygen to the brain and the upper extremities are re-implanted. During the procedure, which should be performed using a heart-lung bypass machine, blood and oxygen is supplied to the brain with separate catheters.