Thoracic endovascular aortic repair (TEVAR) is a minimally invasive procedure used to treat diseases and conditions of the thoracic aorta, which is the section of the aorta located in the chest. Your aorta is the main artery of your body that supplies oxygenated blood to the circulatory system.
These disease conditions often include:
TEVAR is a preferred option over traditional open-chest surgery for many patients because it is minimally invasive. This typically means smaller incisions, less pain, shorter hospital stays, and a faster recovery period compared to open surgery. It also often reduces the risks associated with major surgery, such as significant blood loss and longer anesthesia times.
Similar to endovascular aortic aneurysm repair (EVAR) for abdominal aneurysms, the primary goal of TEVAR is to prevent catastrophic events like aortic rupture (which is often fatal) or to seal off tears/lesions in the aorta.
When faced with a complex and life-threatening condition of the thoracic aorta, such as an aneurysm or dissection — a tear in the inner layer of the aorta — you need to be able to depend on the expertise of your medical team and the capabilities of your health care providers. At AHN, we offer specialized care for TEVAR, working to achieve optimal outcomes for our patients. Choosing AHN for your TEVAR procedure means:
Choosing AHN for TEVAR means placing your care in the hands of a highly specialized team that combines leading expertise, advanced technology, and a deep commitment to your safety and long-term health. We are dedicated to providing the best possible outcome for your complex aortic condition.
Thoracic endovascular aortic repair (TEVAR) is a significant but often minimally invasive procedure performed to repair problems in the large artery (aorta) in your chest. Understanding what to expect can help ease concerns. A TEVAR procedure is performed in a hospital setting, typically in a specialized operating room equipped with advanced imaging technology, or sometimes in a dedicated cardiac catheterization lab. This ensures you have access to a full medical team and necessary equipment for your safety and care.
Prior to the procedure, your AHN care team will review all your current medications. You may be instructed to stop certain medications, particularly blood thinners, for several days or a week before the procedure to reduce the risk of bleeding. You'll have opportunities to speak with your vascular surgeon, anesthesiologist, and nurses to understand the procedure, potential risks, and recovery process. This is the time to ask any questions you may have.
On the day of the surgery, you will arrive at the hospital a few hours before your scheduled procedure. Your nurse will take your vitals and help you get ready for surgery. The anesthesiologist will discuss the plan, because the procedure is done under general anesthesia. You will then be brought to the operating room.
A TEVAR procedure typically takes two to four hours, but this can vary depending on the complexity of your specific aortic anatomy and the extent of the repair needed. Using X-ray guidance and specialized catheters, your surgeon will carefully navigate a stent graft (a fabric-covered tube) through your femoral artery, up into your chest, and precisely position it within the diseased section of your aorta.
Once in place, the stent graft is deployed and expands to reinforce the weakened or damaged part of the aorta, redirecting blood flow through the graft and away from the problem area. After successful deployment, the delivery system is removed, and the incisions in your groin are closed, often with sutures or special closure devices.
You will be moved to a recovery area or, for some patients, the ICU for close monitoring as you wake up from anesthesia. Nurses will regularly check your vital signs, the surgical access sites, and the circulation in your legs and feet. You may experience some mild pain or discomfort at the incision sites, which will be managed with medication.
Once you are stable enough to be moved to general recovery, you will continue your healing under the care of your recovery team. They will manage your pain medication, help you start to regain movement, and monitor your vitals. You’ll likely be on a clear liquid diet and eventually progress to a regular diet as tolerated. Most patients can expect to stay in the hospital for two to four days after the TEVAR procedure, but that varies given each person’s overall health.
Once you are discharged, you will continue to recover at home. It's important to get plenty of rest during the first few weeks at home. While you should avoid heavy lifting (usually anything over five to 10 pounds), strenuous exercise, and pushing or pulling, light activities like walking are encouraged. Your doctor will provide specific restrictions. You'll receive instructions on how to care for your groin incisions, keeping them clean and dry. Watch for any signs of infection, such as redness, swelling, increased pain, or discharge. Take the medication you’ve been prescribed as directed and ensure you are getting plenty of rest as your body heals.
With any surgery, you are likely to have questions and possibly concerns. AHN is here to help you feel confident in your treatment and care plan. Your highly skilled team of heart specialists are able to answer any questions you have about the TEVAR procedure, but to help you get started, we’ve included answers to many of our patients’ frequently asked questions. You can use these to guide your conversations with your care team.
Yes, TEVAR (thoracic endovascular aortic repair) is considered a major medical procedure. Although it is less invasive than traditional open-chest surgery for aortic repair, it still involves significant medical intervention. It's performed in an operating room (often with general anesthesia) carries potential risks, and requires a hospital stay. The endovascular part means it's done through blood vessels, typically via small incisions in the groin, rather than opening the chest or abdomen.
The duration of a TEVAR procedure can vary. Typically, it takes two to four hours to complete. However, the exact time depends on several factors, including the complexity of the aneurysm, the patient's anatomy, and any unforeseen challenges that may arise during the surgery. Preparation before the procedure and recovery immediately afterward will add to the overall time spent in the hospital.
The durability of a TEVAR repair is generally very good. The stent graft used in TEVAR is designed to be a long-term solution. Most studies and clinical experience suggest that TEVAR repairs can last for 10 to 15 years or even longer for many patients.
However, it's important to understand that it's not always a "one and done" procedure. Patients who undergo TEVAR require lifelong follow-up with imaging tests (like CT scans) to monitor the stent graft and the aorta. This is to ensure the graft remains in place, that there are no leaks (endoleaks), and that the aneurysm isn't growing or causing new issues. Sometimes, a re-intervention or additional procedure might be needed years down the line to maintain the repair.
What is endovascular repair of a thoracic aortic aneurysm? Endovascular repair of a thoracic aortic aneurysm is a minimally invasive procedure used to treat an aneurysm in the thoracic aorta. This includes:
The primary goal of this repair is to prevent the aneurysm from rupturing, which is a life-threatening event, while avoiding the more extensive and higher-risk open-chest surgery.
If you have not been formally diagnosed, call (412) DOCTORS 412-362-8677 to see your primary care provider to explore all possible causes of your symptoms. Depending on your symptoms, they can determine if you need to see a general cardiologist for further evaluation. To schedule an appointment with a vascular surgeon and be evaluated to determine if this procedure is right for you, please call 412-359-8820.
