Quality of Life

"Elective" vs. "Emergency" Aortic Surgery

Operations on the aorta may be performed electively or as emergency surgery. Of those done electively, surgery may be performed 1) to prevent a problem from occurring, or 2) to improve symptoms.

Elective Surgery and Quality of Life

Among patients in the first group (those who undergo surgery in order to prevent problems from developing), elective surgery should provide a brief period of recovery followed by a return to quality and length of life that is identical to a person who never had an aortic problem. In the short-term, certain precautions are necessary, such as protecting the breastbone while it is healing. After the initial period of healing, patients may resume a normal quality of life including exercise and active living.

It should be emphasized that there are some parameters regarding what constitutes 'normal' life. For example, patients who are active weightlifters can resume weight-training within reason. Previous studies have demonstrated that lifting 80% of one's body weight will raise the blood pressure in the aortic root to over 300, which is extremely high and should be avoided. Weight training to 50% of one's body weight will still keep you toned and will avoid creating additional problems in your aorta. If you have a connective tissue disorder, you will need follow-up monitoring each year on the rest of your aorta. You are also at risk of developing joint issues, so be careful with contact sports.

For all patients who had an elective procedure, you should approach life as if you had a perfect repair. Go live and enjoy yourself! In patients with valve-sparing operations, you will need follow-up of your repaired valve. An echocardiogram should be performed at 6 months and then every year afterwards, so we can keep an eye on the quality of the repair. If you had an aortic valve replacement, similarly, you should have follow-up with an echocardiogram at 6 months and then each year.

Emergency Surgery and Quality of Life

If you had surgery for an aortic dissection, the hope is that the repair was able to completely reconstruct your aorta without any residual deficit. To the extent that such an outcome was achieved, again, go live and enjoy your life. You are among the lucky people who made it to the hospital alive and had a successful repair. It is important to maintain blood pressure control, as the remaining aorta is still at risk for problems. You will need careful follow-up with yearly CT scans to keep an eye on the aorta. Beyond that, you can expect to live an active lifestyle. The most important thing to expect is that you will feel weak after surgery. It is a traumatic experience. Your body will draw energy from muscle tissue (a great source of fuel). The downside of this is muscle breakdown and loss of energy. You need to work hard after recovery to build back endurance and muscle tone. This is especially difficult for patients over 40, which is when we begin to lose our ability to build muscle. Daily exercise (especially walking) is the rule. Ultimately, you will recover and you will regain the quality of life that you would have had in the absence of an operation.