Wed, 03/16/2016

Diseases of the aorta - When must what be treated?

The answer to this questions lies in the individual problems of the patient which must be carefully assessed before treatment can start. Diseases of the aorta include: aneurysm, dissection, rupture, perforated ulcer etc.. All of these are being treated at the renowned Vascular Center Berlin-Brandenburg Hubertus Hospital in Berlin. The Vascular Center is specialised in the treatment of the aorta. It lies in the interplay of many years of experience, the use of a hybrid OR, the use of minimally invasive surgery, a 24-hour emergency preparedness and the access to almost all stent grafts available in Germany. This ensures that the patient is always getting the stent graft best suited for his individual indication, situation and anatomy.

An aortic aneurysm, which can occur at different locations should be treated if it has a size of about 5 cm. If it is smaller, an operation is only needed when the growth is more than half a centimeter per half year. In addition, all patients should be treated with an aneurysm, who have lower back pain.

Also operated on at an early stage, must eccentric aneurysms and perforated ulceras of the aorta. Although this depends on the morphology of the aneurysm, which is made visible with CT or ultrasound. It might be that such aneurysms must already be operated on when their size is only three centimeters.

In the hybrid OR of Hubertus Hospital, which is in use since 2014, stent grafts are introduced minimally invasive into the aorta with catheters. Using minimally invasive techniques is a gentle method by which the recovery of the patient will be accelerated. This is especially a huge help for older and sicker patients.

In the thoracoabdominal area where the vessels supplying the intestines, the liver, spleen and kidneys come off, custom-made fenestrated and branched stent grafts are being used. This is relatively complex and requires a precise and accurate preparation.

Arch aneurysms or dissections that occur in the bow area, are treated at Hubertus Hospital with hybrid operations. If there is a pathology in the aortic arch, the head and neck vessels are placed forward in a kind of bypass surgery. Then the pathology is treated minimally invasive in the bow with a stent graf.

Dissections require immediate admission to a qualified center. A dissection of the ascending aorta requires the cardiopulmonary bypass.

All other pathologies of the entire aorta as well as thoracic and aortical ruptures can be treated at Hubertus Hospital at any time regardless of whether the rupture originated spontaneously, traumatically or iatrogenically with open surgery or minimally invasive treatment by inserting a stent graft. Ruptures must be operated on immediately. The Hubertus Hospital has this experience and logistics, and a 24-hour standby to perform emergency surgery right away.

The team at Hubertus Hospital can deal at any time all kinds of damages at the aorta. Each elective patient is presented in the interdisciplinary conference, where the therapy is discussed and determined by angiologists, vascular surgeons and radiologists.

The Department of Vascular Surgery and Endovascular Therapy at Hubertus Hospital is headed by Chief Physician Prof. Dr. med. Ernst Weigang, MBA (left in picture above).