Thoracoabdominal Aortic Aneurysm (TAAA Repair)

The renowned surgeons affiliated with Memorial Hermann have extensive experience with complex cardiovascular procedures. Thoracoabdominal aortic aneurysm (TAAA) repair requires a team of highly skilled and experienced physicians. 

TAAA repair carries substantial risks, including paralysis. The surgical methods used at Memorial Hermann have resulted in a significant reduction of these risks. Since 1992, the incidence of paralysis has decreased from 15% to less than 3% at the Memorial Herman Heart & Vascular Institute.

What Is TAAA Repair?

This complex surgical procedure removes a weakened section of the aorta and replaces it with a fabric tube called a graft. TAAA repair is one of the most complex aortic repair procedures.

The portion of the aorta that is located in the chest is called the thoracic aorta. The portion of the aorta that is located in the abdomen is called the abdominal aorta. Aneurysms can occur anywhere along the aorta. Aneurysms that involve both the thoracic and abdominal aorta are called thoracoabdominal aneurysms.

During open aneurysm repair, your surgeon makes an incision in your chest and abdomen and replaces the weakened portion of your aorta with a graft. The graft is stronger than the weakened aorta and allows blood to pass through it without causing a bulge, nearly eliminating the risk of rupture and death.

At the start of the procedure, the physician will insert a catheter to drain spinal fluid to increase blood flow to the spinal cord. This reduces the risk of postsurgical paralysis.

Patients with a large thoracoabdominal aneurysm may require surgical repair. In addition to the potential for the aneurysm to rupture, aortic dissection is another risk with this type of aneurysm.

Aortic dissection happens when the layers of the aortic wall separate from each other. This is a possible side effect of having a thoracoabdominal aneurysm. When dissection occurs, you may experience severe pain in your chest or back. Both aneurysm and dissection can lead to death.

Abdominal aneurysms are often caused by a build-up of fatty deposits in the arteries (atherosclerosis). Several health factors may contribute to the development of atherosclerosis and ultimately lead to an aneurysm:

• High blood pressure
• High cholesterol
• Obesity
• Smoking
• Family history of cardiovascular disease

Sometimes, other diseases like Marfan syndrome or other connective-tissue disorders can cause aortic aneurysms that require surgical repair.

What Are The Benefits of TAAA Repair?

As the TAAA enlarges, the risk of rupture (like a water balloon) increases. By having the TAAA repair procedure, patients will greatly reduce their risk of rupture-related death. The procedure is complex and has risks involved, but it is often necessary to resolve the aneurysm.

You will receive general anesthesia so you will not feel pain during the procedure, and you will not remember the procedure. Once you are asleep, the physician will place a lumbar drain in your spinal column to drain fluid during surgery. This greatly reduces the risk of paralysis.

The surgeon will make an incision in your chest and abdomen. The length of the incision will be determined by the length of the aorta that needs to be replaced. Once the diseased section of the aorta is removed, the surgeon will place a woven graft in its place, and then close the incision.

During surgery, you will be connected to a heart-lung bypass machine. This machine functions as your heart and lungs while you are asleep, and it can stop the flow of blood to the surgical site, which is necessary to complete the procedure.

TAAA repair is a complex procedure with risks involved. Some potential complications include:

• Infection
• Bleeding
• Blood clots
• Blood leakage around the graft
• Movement of the graft out of the correct position
• Stroke
• Heart Attack
• Kidney Injury

Another risk with the TAAA repair procedure is paralysis of the legs. The lumbar drain placed in your spinal column during surgery will greatly reduce this risk. Most patients will have the drain removed within a day or two after surgery.

Following TAAA repair surgery you will stay in the intensive care unit (ICU) for a few days and then move to a regular hospital room. While the lumbar drain is still in place, you will need to lay flat on your back. When it is removed, you may sit up and begin regaining strength to get out of bed.

This procedure will cause post-operative pain and your care providers will work with you to manage the pain. When you are discharged, you will need a trusted friend, family member or caregiver to stay with you for the first week.

Full recovery may take 2 to 3 months. Speak with your physician and care team to develop a rehabilitation plan so you can slowly return to everyday activities. A cardiac rehabilitation program can be very helpful.

Repairing a thoracoabdominal aneurysm requires highly trained specialists who are experienced with the latest surgical techniques.

To learn more about TAAA repair, visit Find a Doctor to schedule an appointment with one of our affiliated specialists.