Keeping the Beat: Advanced Heart Surgery for Aortic Aneurysm

A problem with your aortic root can disrupt the flow of blood throughout your body, leading to shortness of breath, chest pain, and more. Virtua cardiothoracic surgeons are among the few specialists in the region performing valve-sparing aortic root replacement.

Updated October 25, 2024

By Chun (Dan) Choi, MD, Cardiothoracic Surgeon and Eden Payabyab, MD, Cardiothoracic Surgeon — Virtua Cardiology

You’ve probably heard your cardiovascular system compared to plumbing. Arteries, veins, and capillaries act like pipes, carrying blood to where it’s needed. Your heart is the pump, ensuring your blood keeps moving through the pipes.

Your aortic root—the point where your blood moves from the heart into the aorta, the largest artery in the body—is the water main. A problem here can disrupt the flow of blood throughout your body, leading to shortness of breath, chest pain, and more.

Virtua cardiothoracic surgeons are among the few specialists in the region to treat a damaged aortic root while keeping your own aortic valve, the “door” that manages blood flow from the left ventricle to the aorta.

The procedure, called valve-sparing aortic root replacement, is a better option for people who have an aortic root aneurysm but have an otherwise functional valve. They can keep their own valve and not worry about another surgery to replace it down the road.

Root Causes of Aneurysms

An aortic aneurysm is an abnormal widening of the aortic root. If it grows too wide, the valve may not close fully, allowing blood to flow backward and causing chest pain, shortness of breath, and fainting.

The walls of the aorta may weaken for a variety of reasons, including chronic high blood pressure, atherosclerosis, and smoking. Aneurysms are also linked to genetic disorders of connective tissues—the fibers that support the organs and other structures in your body—like Marfan and Elher-Danlos syndromes.

A tear in the aorta can be fatal.

Aneurysms are often discovered during an imaging scan for another medical condition. The goal is to treat the aneurysm before it becomes too large and is at risk of bursting.

Fixing the Plumbing

During the procedure, the surgeon makes an incision in your chest to gain access to your heart. You are placed on a heart-lung bypass machine, which takes over your breathing and heart function.

The surgeon removes the damaged portion of your aorta, just above the valve, and replaces it with a synthetic graft. They then connect the graft to your valve, ensuring the valve’s leaflets can open and close properly. The coronary arteries are reattached as well.

You are removed from the bypass machine at the conclusion of the surgery.

The procedure takes about five hours, and you can expect to stay about four days in the hospital.

It’s important to have this procedure at a hospital with highly experienced heart surgeons. To re-implant the valve in a synthetic graft root takes a lot of nuance and subtlety. If you get it wrong, you can have a leaking valve.

An alternative procedure replaces the entire root, including a new mechanical valve. While effective, patients need lifelong blood thinners and will likely need to replace the valve in 10 to 12 years. For certain patients, especially those who are younger and don’t want to take blood thinners or undergo another surgery, the valve-sparing approach is a good option.

Put Your Heart in the Right Place

Virtua’s heart surgery program is a leader in offering innovative, minimally invasive procedures that reduce pain and shorten your recovery time. Call 856-547-0389 to request an appointment.