Aortic arch replacement is open-heart surgery to replace a damaged section of the aortic arch — the curved part of the aorta. The aorta is the main artery that carries blood from the heart to the rest of the body.
This surgery is usually done to treat an aneurysm in the aortic arch. An aneurysm is a weak, bulging area in the blood vessel wall. If it gets too large, it can tear or rupture, which can be a life-threatening emergency. A torn or ruptured aorta can cause poor blood flow to the organs, internal bleeding, stroke, organ failure, and even death.
During aortic arch replacement, the aneurysm is removed and the arteries that carry blood to the brain and upper body (arch vessels) are reconstructed. This surgery prevents serious problems caused by the aneurysm.
At Mass General Brigham Heart and Vascular, our highly trained cardiac surgeons have performed thousands of complex aorta surgeries with excellent results.
You may need this procedure if the aortic arch is:
There are different ways to repair the aortic arch:
Several of these techniques are highly specialized and only available at select centers across the country, including Mass General Brigham.
We also have access to advanced tools and technologies that aren’t widely available, including:
Our expert team will carefully evaluate your condition to decide which approach is best for you.
Aortic arch replacement prevents life-threatening complications by repairing or replacing a damaged aorta before it causes serious health emergencies. Without treatment, a weakened aortic arch can lead to poor blood flow to the organs, internal bleeding, stroke, organ failure, and even death.
Aortic arch replacement eliminates the risk of serious problems caused by an aneurysm. After recovery, many patients are able to return to the activities they enjoy and live full, active lives.
Aortic arch replacement surgery also helps improve symptoms of aortic arch damage, such as:
Before this procedure, your care team will explain what to expect, answer your questions, and guide you through preoperative tests to assess your heart and make sure you are ready for surgery.
You may have:
You may need to stop taking some medications prior to surgery, so it’s important to let your surgeon know about everything you take. The night before surgery, you will need to stop eating and drinking as instructed. Your care team will provide specific pre-surgery guidelines to help you prepare for a safe and successful procedure.
You will have anesthesia during surgery to keep you comfortable and pain-free. Your surgical team, including specialists from multiple disciplines, will closely monitor your blood flow, oxygen levels, and vital signs. The surgery may last up to six hours.
During aortic arch replacement, your surgeon:
You’ll wake up after surgery in the intensive care unit (ICU) to begin your recovery. You will be connected to a heart monitor and may have:
You’ll stay in the hospital for about five to seven days. During the first few days, you’ll be closely monitored in the ICU. As you get stronger, we’ll remove tubes and pacing wires and move you to a regular hospital room.
Before you go home, your care team will check that you can:
If you’re not quite ready to go home, we’ll work with your insurance to coordinate inpatient rehab. There, you’ll continue your recovery with support from our team.
Once you are strong enough to continue healing at home, we provide:
Most patients are not in pain by the time they leave the hospital. Over-the-counter pain medicine is usually enough. You’ll start to feel more like yourself in four to six weeks.
You will need to take about six weeks off work and avoid driving during that time. Your care team will let you know when it’s safe to return to work, drive, and resume your usual routine.
Take extra care during the first few months. Don’t lift anything heavy for about three months while your body continues to heal.
Complications of aortic arch replacement surgery are rare, but every major surgery has the potential for complications. Risks of aortic arch replacement include:
In some cases, aortic arch aneurysms can be treated without open surgery. Our team may be able to use a minimally invasive procedure called endovascular repair, which uses a stent graft to reinforce the weakened area.
We’ll carefully evaluate your condition to decide if this approach—or another treatment—is the best and safest option for you.
The success rate of aortic arch surgery depends on many factors, such as the type of surgery, your age, and other health conditions. For most people, aortic arch surgery successfully corrects the problem.
A double aortic arch is a congenital condition. It happens when blood vessels form around the trachea (windpipe) and esophagus, creating a second aortic arch. Surgery is necessary to repair a double aortic arch.
