Surgery may be needed to repair your aortic dissection. Your care team will determine which surgery is best for your needs. The Northwestern Medicine Center for Aortic Care at Bluhm Cardiovascular Institute performs minimally invasive (endovascular) repair surgery to treat certain aortic dissections.

Endovascular repair surgeries include:

• Thoracic endovascular aortic repair (TEVAR)
• Fenestrated endovascular aortic repair (FEVAR)

Endovascular repair surgery is needed when an aortic dissection reaches a significant size. The type of repair offered depends on the location and extent of the aortic dissection. Your care team will talk with you about treatment options. They will explain procedures and answer your questions.

Endovascular repair surgeries have several benefits because they are minimally invasive:

• Less pain
• Faster return to normal daily activities
• Less blood loss
• Improved clinical outcomes
• Smaller incisions with less scarring
• Shorter recovery time

How Endovascular Repair Surgery Works

A surgeon inserts a small catheter (hollow, flexible tube) into your femoral (leg) artery through a tiny incision in your groin area. The catheter has a stent graft (usually a metal mesh tube covered with fabric).

Then, the surgeon moves the catheter into the diseased part of the aorta. This enables them to place the graft. The graft directs blood through the graft and away from the dissection.

Thoracic Endovascular Aortic Repair (TEVAR)

During TEVAR, the surgeon uses special tools and X-rays to guide an expandable stent graft through your femoral artery into the aorta. A stent graft can be used to repair an aortic dissection. The surgeon places the expandable graft inside the damaged aorta and opens it. This makes the graft expand and fit snugly in place.

Fenestrated Endovascular Aortic Repair (FEVAR)

"Fenestrated" endovascular grafts are unique grafts customized to fit the patient’s aortic needs. Fenestrated grafts have small openings that allow blood flow to be restored to the arteries that branch off of the aorta and supply blood to critical organs.

The surgeon removes the diseased aorta and replaces it with a graft. The aorta has many arteries that provide blood to different parts of the body. The surgeon detaches these arteries from the aorta. Then, they replace part of the arteries with fenestrated grafts to restore blood flow.