Cardiovascular Surgery Specialist Prof. Dr. Selim İşbir gave information about the subject. The aorta is the main vein that comes out of our heart and distributes blood throughout our body. In fact, it is a very important organ of ours. The most important disease of the aorta is the enlargement of the aorta, which we call "Aortic Aneurysm". The disease is more common in smokers. In addition, high blood pressure is among the most important risk factors in the formation of aortic aneurysms.
Aortic Aneurysm
Aortic Aneurysm is a very serious, life-threatening disease with an insidious course and mostly asymptomatic. The enlargement of the aortic vessel in the abdominal cavity is called “Abdominal Aortic Aneurysm”. If this enlargement starts from the point where the aorta emerges from the heart in the chest cavity, it is called "Ascending Aortic Aneurysm".
In whom is the disease more common and what are the symptoms?
It is more common in men who smoke, over 60 years of age, and have high blood pressure. The diagnosis is often made by chance during examinations performed for another reason. There is no screening program for this disease in our country.
How Do We Diagnose?
Diagnosis is actually very simple. Echocardiography is diagnostic in aneurysms in the chest cap, and ultrasonography in aneurysms in the abdominal cavity. The main diagnosis is made by tomography.
What consequences can the disease have?
The most important consequence of the disease is the bursting of the vessel when it reaches a certain diameter. In this event, which we call “rupture”, the chance of death is high. Therefore, the disease should be treated before it reaches this point. Generally, this rate increases when the vessel diameter is 5 cm or more. Therefore, the follow-up of these aneurysms and their treatment when it reaches the intervention limit are of great importance in order to prevent unexpected rupture of the aneurysm.
Is it possible to prevent the disease?
The disease is more common in people who smoke, have high blood pressure, and have a family history of aneurysm. In short, smoking and high blood pressure are the factors that can be controlled among these factors, which we define as general risk factors for cardiovascular diseases. Human genetics cannot be changed. On the other hand, it is not possible to treat the disease with medication.
How is the treatment done?
Treatment options vary according to the location of the aneurysm. If the aneurysm starts from the point of exit from the heart in the chest cavity, the only option in these aneurysms is to remove the enlarged part by open surgery and replace it with an artificial vessel. On the other hand, in the aneurysms in the thoracic cavity far from the heart and in the aneurysms in the abdominal cavity, a stents placed in the vein with small incisions made in the inguinal region today. In short, this method, which we call Endovascular repair, provided great comfort for the patient. In the past, in open surgery, patients would stay in the intensive care unit for 1-2 days and then in the hospital for 5-7 days depending on the changing conditions. In open surgery, blood use due to bleeding and infection rates were quite high. In addition, the patients' return to their normal lives included a period of 1, 1.5 months if everything went well. In the endovascular repair method, patients can be discharged from the hospital within 1-2 days and then return to their normal lives in about 1 week. In addition, blood use and infection rates are negligible when compared to the open surgery method. However, this method may not be suitable for every abdominal aortic aneurysm patient. In this case, the old method should be treated.
Endovascular Repair: prof. Dr. Selim İşbir, “The most important innovation in aortic surgeries in recent years is "Endovascular" repair. Aortic aneurysms are the surgeries with the highest risk of bleeding among heart surgeries. In addition, due to the other vessels going from the aorta to our brain and internal organs, it is highly likely that new problems will arise in paralysis and other organs during these operations. Endovascular repair minimized these problems. In the method we call endovascular repair, a stent covered with a special fabric called polyester or PTFE is placed into the aneurysm with the help of a catheter through the groin, thus deactivating the aneurysm. In aortic aneurysms, different endovascular interventions can be performed depending on the region of the aneurysm. The procedure should be performed in operating rooms with special equipment. These places, called hybrid operating rooms, are special places within the operating room units of hospitals where "angiography" can be performed at the same time. Since it is a very expensive investment, it is not available in every hospital. Endovascular repair may not be suitable for every patient due to the vessels coming out of the aorta and going to the brain and internal organs. In this case, combined endovascular repairs with open surgeries performed in hybrid operating rooms have the chance to be performed with better results than conventional surgeries.”
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