Aortic Prosthesis

An aneurysm is a local dilation of the aortic wall forming a "sac." The danger is that the wall thins and may rupture, and aortic rupture is a life-threatening condition. An aneurysm can go without symptoms for a long time.

A diameter of 5 cm or more is considered critical, as is growth of 6 mm or more over 6 months. The exact indications are determined by the surgeon based on CT aortography data.

There are two main methods: open surgery (replacing the segment of the aorta with a synthetic graft, universal for any part) and the endovascular method — placing a stent-graft through punctures in the thigh, without a large incision. The method is chosen by the cardiovascular surgeon.

With the endovascular method (EVAR), only small punctures are made in the thigh and a stent-graft is placed inside the aneurysm — this is minimally invasive with a short recovery. Open surgery is more universal and can correct any lesion, but requires cardiopulmonary bypass and a longer rehabilitation.

The ascending aorta, the arch, and the thoracic and abdominal aorta. For an ascending aorta aneurysm with aortic valve involvement, the aorta is replaced together with the valve.

An aneurysm often causes no symptoms for a long time. As it grows, pain, a sense of pulsation, and disturbances from compression of nearby organs may appear. Sudden severe pain may indicate dissection or rupture — a reason for immediate medical help.

The main method is multislice CT aortography with intravenous contrast. It provides complete information about the location, diameter and extent of the aneurysm and its relationship to nearby organs, which determines the surgical approach.

After endovascular repair (EVAR), patients usually spend 1–3 days in hospital and return to daily activity within 1–2 weeks. After open surgery, recovery takes longer and is determined individually.

Aortic prosthesis is a well-established procedure performed by experienced surgeons. As with any surgery, there are risks (for the endovascular method, for example, leaks around the stent-graft are possible), which are controlled by monitoring and minimized by the specialist team.

At Pirogov Clinic in Saint Petersburg, aortic prosthesis is performed free of charge under Compulsory Health Insurance (CHI) and federal high-tech medical care quotas, when indications and a referral are in place.

A referral and confirmed indications are required. Book a consultation — specialists will assess your case and help arrange the quota and prepare the necessary documents.

Once it reaches a critical size, an aneurysm can rupture, and aortic rupture is often fatal. Timely prosthesis eliminates this risk and restores normal blood flow.

Before the procedure, a full diagnostic workup is performed, primarily CT aortography, along with tests to assess overall condition. The treating physician draws up an individual preparation plan at the consultation.

Yes. After surgery, regular follow-up with a specialist and check-up imaging are important, along with following the doctor's recommendations — this allows the condition of the graft and the aorta to be assessed in time.