What is thoracic endovascular aortic repair (TEVAR)?
Thoracic endovascular aortic repair (TEVAR) is a procedure to correct an aneurysm in the upper portion of your aorta.
An aneurysm is a weakened, bulging area in the artery wall. If it ruptures, it can be life-threatening.
In TEVAR, a graft made of metal and polyester is positioned to reinforce the aneurysm. This will help prevent it from rupturing.
Why might I need a TEVAR?
The aorta is your body’s largest artery. It carries oxygen-rich blood from your heart to the rest of your body. It extends from your heart through your chest and into your abdomen. There, it divides into blood vessels that provide blood flow to your legs.
Sometimes, a weakened area of the aorta bulges out. This is called an aortic aneurysm. An aneurysm of the aorta is serious because it can rupture.
The risk of rupture increases as the aneurysm grows. Treatment depends on the size of the aneurysm. Treatment also depends on how fast the aneurysm is growing.
Your healthcare provider may recommend TEVAR to repair an aneurysm that occurs in the part of the aorta above your diaphragm (the thoracic area).
What are the risks of TEVAR?
For this procedure, you will receive either spinal or general anesthesia. Any general anesthesia carries the risk of heart or brain injury.
Major surgery also carries the risk of blood clots forming during or after surgery. These clots can break free. If a clot travels to your lungs, it can cause a pulmonary embolism. If a clot travels to your brain, it can cause a stroke.
Other risks of this procedure include:
Also, your aortic aneurysm may continue to expand after your surgery.
There may be other risks, depending on your specific medical condition. Be sure to talk to your healthcare provider to about any concerns you have before your procedure.
How do I prepare for TEVAR?
Ask your healthcare provider to tell you what you should do before TEVAR. Below is a list of common steps that you may be asked to do.
Before the procedure:
Your healthcare provider will explain the procedure and ask if you have any questions.
You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if something is not clear.
In addition to a complete medical history, your healthcare provider(s) may do a physical exam to ensure you are in good health before the procedure. You may also have blood and other diagnostic tests.
If you are pregnant or think you may be, tell your healthcare provider(s).
Tell your healthcare provider(s) if you are sensitive to or are allergic to any medications, latex, iodine, tape, contrast dyes, and anesthetic agents (local or general).
Tell your healthcare provider(s) of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
Your healthcare provider may prescribe medicines to take in the days leading up to your surgery. These medicines can help relax blood vessels, lower blood pressure, and minimize the risk of your aortic aneurysm bursting.
If you take any blood-thinning medications like warfarin or aspirin, tell your healthcare provider before your surgery. These can increase your risk of bleeding during the procedure.
Since you will have anesthesia (medicine to make you sleep during TEVAR), your healthcare provider will probably tell you not to drink or eat anything after midnight the night before surgery.
If you smoke, you should stop smoking as soon as possible prior to the procedure. This can improve your chances for a successful recovery from surgery. It can also improve your overall health status.
Based on your medical condition, your healthcare provider(s) may request other steps.
What happens during TEVAR?
TEVAR is a minimally invasive surgery. That means it does not involve large incisions.
Your surgeon will attach a synthetic stent graft, made from metal and polyester, to the end of a catheter (a thin tube).
Using X-rays as a guide, your surgeon will thread the catheter, with the graft attached, through an artery in your groin to the affected part of your aorta.
Once positioned, your surgeon will expand the graft’s metal frame and fasten it into place.
The metal frame expands like a spring and attaches tightly to the wall of your aorta. This provides a stable place for blood to flow. It also prevents your aneurysm from rupturing. The blood supply is also cut off from the aneurysm, causing it to shrink over time.
Talk with your healthcare provider about what you will experience during your procedure.
What happens after TEVAR?
Recovery time from TEVAR is shorter than recovery from traditional surgeries to correct aortic aneurysms.
Your healthcare provider may give you other instructions about what you should do after TEVAR. Here is a typical list:
Expect to stay in the hospital for at least 3 to 4 days.
Avoid strenuous activity for at least 4 weeks. Check with your healthcare provider on when it maybe safe to resume driving. Plan to have someone give you a ride home on the date of your hospital discharge.
Watch your incision site for signs of infection. These include redness, swelling and pain.
Your healthcare provider may order CT (computed tomography) scans at regular intervals to check for leaks, any breakdown of your graft, and other problems.
After you go home, your healthcare provider may instruct you to take blood-thinning medications to prevent blood clots.
Ask your healthcare provider what types of foods that should eat and what types of foods to avoid once you are at home. The recommended diet will depend on all of your healthcare needs.
Your healthcare team will inform you when to schedule your follow up appointment to monitor your progress and recovery.
Remember to take all your medications as prescribed.
Next stepsBefore you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
The risks and benefits of the test or procedure
When and where you are to have the test or procedure and who will do it
When and how will you get the results
How much will you have to pay for the test or procedure