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Aneurysm of the thoracic aorta

Thu, 12/06/2012 - 13:25 Cardiology
Aneurysm

Aneurysm of the thoracic aorta is most often asymptomatic and is usually detected incidentally during chest CT, performed for other reasons (i.e. bronchitis).  
However, if symptoms are present, they include:

  • Intensive, "tearing" chest pain or back pain between shoulder blades.
  • Shortness of breath, hoarseness, cough (due to pressure on the lungs and airways).
  • Difficulty in swallowing (pressure on the esophagus).

A small aneurysm (5 cm in diameter in the area of the outer aortic wall protrusion) is usually not a threat and require continuous monitoring only (for at least 9 to12 months).  A large aneurysm (more than 5 cm in diameter) is hazardous. Rupture of such aneurysm can lead to loss of consciousness, stroke, shock or heart attack, and therefore should be treated immediately.
Treatment is an open chest surgery, during which a special stent is inserted in the area of the aneurysm. Sometimes several stents have to be inserted, depending on the length and number of aneurysms along the aorta.
Manor Medical Center offers a unique program for treating the aneurysm of the thoracic; it includes the best medical team in Israel, and surgery in-the-state-of-the-art hospital. Preparation for surgery is done in one day!
Before arriving in Israel, the patient must submit a CT, which shows the aneurysm. CT images are examined by a cardiologist and a radiologist in order to decide on the suitability of the proposed treatment.  
On the morning, after patient's arrival in Israel, he/she undergoes laboratory tests, and a high-resolution angiography from the neck to the groin. A few hours later the angiography is delivered to the radiologist, who calculates the diameter and number of the stents required. After that stents are ordered from the supplier.
At the same time the patient consults a cardiologist and a radiologist, and undergoes preoperative examinations - EKG, chest x-ray, consultation of an anesthesiologist.

The next day everything is ready for the operation on an aneurysm of the thoracic aorta
The surgery lasts at least 3 hours. Contrast material is injected into the femoral artery, a heart surgeon accesses the chest in the area of the thoracic aorta, and interventional radiologist installs the stent using navigational aortography (STENT-GRAFT).

After the surgery the patient spends one night in the intensive care unit, and then transferred to the cardio ward another for 2 days.  
Usually, there are two symptoms that require monitoring after this type of surgery, - the temperature and pain in the hip area; they also affect the date of discharge from the hospital. Hip blood vessels are monitored by Doppler echocardiography.

Costs:

  • Advanced blood tests (general, biochemistry, lipids, electrolytes, coagulation) - $ 670;
  • Computer angiography of high resolution - $ 990;
  • Consultation of the cardiologist - $ 550;
  • Consultation of the Radiologist - $ 550;
  • Preoperative exams (EKG, chest x-ray, anesthesia consultation) - $ 540;
  • Surgery for correction of the thoracic aorta including the installation of a stent, and 3 days of hospitalization, including the cost of one stent - $ 75.900;
  • The cost of an additional stent (if necessary) - $ 13.850;
  • The cost of additional days of hospitalization - $ 1.140.


10 days after surgery stitches are removed. If necessary, computer angiography of the chest is performed at the same time.

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