page_title: Open aortic surgery
section_title: Technique
hierarchical_section_title: Open aortic surgery / Technique
caption_attribution_description: English: Front wall suture line of an infrarenal open aortic repair with a dacron bifurcated graft in a model
context_page_description: Open aortic surgery, also known as open aortic repair, describes a technique whereby an abdominal or retroperitoneal surgical incision is used to visualize and control the aorta for purposes of treatment. OAS is used to treat aneurysms of the abdominal and thoracic aorta, aortic dissection, acute aortic syndrome, and aortic ruptures. Aortobifemoral bypass is also used to treat atherosclerotic disease of the abdominal aorta below the level of the renal arteries. In 2003, OAS was surpassed by endovascular aneurysm repair as the most common technique for repairing abdominal aortic aneurysms in the United States. In OAS for abdominal aortic aneurysm, the aneurysmal portion of the aorta is replaced with a graft, usually made of dacron or PTFE.
  OAS is distinct from aortic valve repair and aortic valve replacement, as OAS describes surgery of the aorta, rather than of the heart valves. When the aortic valve is diseased in addition to the ascending aorta, the Bentall procedure is used to treat the entire aortic root.
context_section_description: Open surgery typically involves exposure of the dilated portion of the aorta and insertion of a synthetic (Dacron or Gore-Tex) graft (tube). Once the graft is sewn into the proximal (toward the patient's head) and distal (toward the patient's foot) portions of the aorta, the aneurysmal sac is closed around the graft.
  Alternatively, the anastomosis can be carried out with expandable devices, a simpler and quicker procedure 
  The aorta and its branching arteries are cross-clamped during open surgery. This can lead to inadequate blood supply to the spinal cord, resulting in paraplegia, when repairing thoracic aneurysms. A 2004 systematic review and meta analysis found that cerebrospinal fluid drainage (CFSD), when performed in experienced centers, reduces the risk of ischemic spinal cord injury by increasing the perfusion pressure to the spinal cord. A 2012 Cochrane systematic review noted that further research regarding the effectiveness of CFSD for preventing a spinal cord injury is required.
caption: Front wall suture line of an infrarenal open aortic repair with a dacron bifurcated graft
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