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TEVAR

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What is TEVAR?

Thoracic Endovascular Aortic Repair (TEVAR) is a minimally invasive procedure designed to repair abnormalities in the thoracic aorta, the section of the aorta that runs through the chest. This is done using a stent graft, which is a tube-like device that is placed inside the aorta to reinforce and repair the damaged area.

Why is TEVAR performed?

TEVAR is typically performed to treat:

  • Thoracic Aortic Aneurysms: Abnormal bulges in the aorta that can lead to a rupture if not treated.
  • Thoracic Aortic Dissections: A condition where there is a tear in the inner layer of the aortic wall, leading to separation of the layers and potentially causing life-threatening complications.

How is the TEVAR procedure performed?

The procedure involves:

  1. Preparation: You may need to fast for a few hours before the procedure. TEVAR is usually done under general anesthesia.
  2. Access: A catheter is inserted into an artery, usually in the groin or sometimes through the arm, and guided to the thoracic aorta using imaging techniques like X-rays or fluoroscopy.
  3. Stent Graft Placement: The stent graft is deployed through the catheter and positioned in the aorta to cover the area of the aneurysm or dissection. The stent graft expands and adheres to the aortic wall, restoring normal blood flow.
  4. Completion: The catheter is removed, and the incision site is closed. The patient is then monitored as they wake up from anesthesia.

What should I expect during the procedure?

You will be under anesthesia, so you should not feel any pain during the procedure. You may experience some discomfort or pressure in the area where the catheter is inserted. The procedure typically lasts between 1 to 3 hours, depending on the complexity.

What are the risks associated with TEVAR?

Potential risks and complications include:

  • Endoleak: A condition where blood continues to flow outside the stent graft but within the aorta.
  • Stent Graft Migration: Movement of the stent graft from its original position.
  • Infection: At the catheter insertion site or within the aorta.
  • Bleeding: Either at the insertion site or internally.
  • Stroke: Due to dislodged plaque or clots.
  • Aortic Rupture: A rare but serious complication if the aorta is not adequately repaired.

How long does recovery take after TEVAR?

Most patients can expect a recovery period of about 1 to 3 days in the hospital, with the total recovery time at home varying based on individual health and the extent of the procedure. Many people return to normal activities within a few weeks, but it’s important to follow your healthcare provider’s specific instructions.

What are the aftercare instructions following TEVAR?

The aftercare instructions include:

  • Wound Care: Keep the catheter insertion site clean and dry. Follow instructions for caring for the wound.
  • Medication: You may be prescribed medications to prevent blood clots, manage pain, or reduce the risk of infection.
  • Activity Restrictions: Avoid strenuous activities or heavy lifting for a few weeks as advised by your healthcare provider.
  • Follow-Up Appointments: Regular follow-up visits will be needed to monitor the stent graft and ensure proper healing.

How will I know if TEVAR was successful?

Success is typically assessed through follow-up imaging studies such as CT scans or X-rays to confirm that the stent graft is in place and functioning correctly. Your healthcare provider will also evaluate your symptoms and overall recovery.

What lifestyle changes might be recommended after TEVAR?

Lifestyle changes may include:

  • Healthy Diet: A heart-healthy diet to support overall vascular health.
  • Regular Exercise: Engage in moderate physical activity as advised by your healthcare provider.
  • Smoking Cessation: If you smoke, quitting is crucial for reducing cardiovascular risks.
  • Medication Adherence: Take prescribed medications as directed to manage blood pressure and prevent complications.

Can TEVAR be performed if I have other health conditions?

TEVAR can be performed alongside the management of other health conditions, but your overall health will be evaluated to determine the best approach. Conditions like severe heart disease or other vascular issues may require additional planning and coordination of care.

How does TEVAR compare to other treatments for thoracic aortic diseases?

TEVAR is less invasive than open surgery and typically involves a shorter recovery time. However, the choice between TEVAR and other treatments, such as open surgical repair, depends on factors such as the size and location of the aneurysm or dissection, overall health, and the presence of other medical conditions.