Suture repair of aorta or great vessels; with shunt bypass
CPT4 code
Name of the Procedure:
Suture Repair of Aorta or Great Vessels; with Shunt Bypass
Common Names: Aortic Repair, Great Vessel Suture Repair
Technical Terms: Aortic Suture Repair with Temporary Shunt, Vascular Suture Anastomosis
Summary
This surgical procedure involves repairing tears or injuries in the aorta or other large blood vessels using sutures. A temporary bypass shunt is employed to maintain blood flow during the repair.
Purpose
The procedure addresses conditions like aortic aneurysms, dissections, or trauma-induced injuries to the aorta or major blood vessels. The goal is to restore the structural integrity of the vessels and ensure proper blood flow.
Indications
- Severe aortic aneurysm
- Aortic dissection
- Trauma to the aorta or great vessels
- Persistent bleeding from major blood vessels
- Major vessel abnormalities detected via imaging
Preparation
- Fasting for at least 8 hours prior to the procedure.
- Medication adjustments, particularly blood thinners.
- Comprehensive preoperative assessments, including blood tests, imaging studies (CT, MRI, angiogram), and cardiovascular evaluations.
Procedure Description
- Anesthesia: General anesthesia is administered to the patient.
- Incision: A surgical incision is made to access the aorta or affected vessel.
- Bypass Shunt Placement: A temporary shunt is placed to divert blood flow away from the repair site.
- Suture Repair: The surgeon uses sutures to repair the vessel's wall.
- Removal of Shunt: Once the repair is complete, the bypass shunt is removed.
- Closure: The incision is closed with stitches or staples, and the area is dressed.
Tools and Equipment: Surgical sutures, temporary vascular shunt, clamps, and standard surgical instruments.
Duration
The procedure typically takes 3 to 6 hours, depending on the complexity of the repair.
Setting
The procedure is performed in a hospital operating room equipped for vascular surgery.
Personnel
- Cardiovascular Surgeon
- Surgical Assistants
- Anesthesiologist
- Operating Room Nurses
- Cardiovascular Perfusionist (if bypass machine is used)
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Nerve damage
- Organ damage
- Stroke or heart attack
- Reaction to anesthesia
- Graft or repair failure
Benefits
- Restores blood vessel integrity
- Prevents vessel rupture
- Improves blood flow
- Reduces risk of life-threatening hemorrhage
- Potentially life-saving in emergency scenarios
Recovery
- Intensive Care Unit (ICU) monitoring post-surgery
- Pain management through medication
- Gradual return to normal activity over 4-8 weeks
- Follow-up appointments for imaging and cardiovascular assessments
- Specific activity restrictions to avoid strain on repaired vessels
Alternatives
- Endovascular aneurysm repair (EVAR)
- Medication management for smaller aneurysms or dissections
- Observation with regular monitoring for asymptomatic cases
- Open surgery without shunt in certain scenarios
Pros and Cons of Alternatives:
- EVAR: Minimally invasive but not suitable for all patients; lower immediate recovery time but potential for future interventions.
- Medication/Observation: Non-invasive but does not repair vessel; only feasible for non-critical cases.
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel anything. Post-surgery, there may be discomfort or pain at the incision site, managed with pain medications. In the first few days, patients might experience fatigue and limited mobility, gradually improving as they recover. Regular follow-up and adherence to post-operative care instructions are crucial for a smooth recovery.