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ASCENDING-AORTA SURGERY You need to have surgery on your ascending aorta. This pamphlet you explains how the heart functions and the main steps in the surgery. YOUR HEART The heart is a muscle located in the center of the chest between the lungs. It works like a pump, circulating blood in order to provide the body with oxygen and nutrients. The parts of the heart are the atria, ventricles, valves, and coronary arteries. Valves The Aorta The aorta is the largest artery in the body. It begins at the top of the left ventricle and carries the blood pumped by the heart to the various branches of the circulatory system, which supply all of the body's organs. ASCENDING-AORTA SURGERY Atrium Ventricle Blood circulates in four chambers referred to as the atria and ventricles. The upper two chambers are the atria; the lower two are the ventricles. The heart has four valves that are flap-like tissue structures that open and close with each heartbeat. The valves allow blood to pass through the atria and ventricles, ensuring that blood flows in the right direction. The coronary arteries are located on the surface of the heart, providing it with blood and oxygen. An aneurysm (abnormal bulge) can occur in any of the body's arteries, including the ascending aorta. Ascending-aorta surgery consists in removing the diseased part of the aorta (aneurysm) and reconstructing the artery with synthetic tissue. The aneurysm can also be located near the aortic valve. In such cases, the valve is also replaced during the operation. MAIN STEPS OF THE SURGERY Prosthetic Tube General Anesthesia Before putting you under, the care team will connect you to a cardiac monitor (which measures arterial pressure), a saturometer (which measures blood oxygen level), and an IV drip. Then, you will be anesthetized (put to sleep). Once you have been put to sleep, a tube will be installed to help you breathe as well as a urinary catheter and venous-access lines. An anesthetist will monitor you during the procedure. Opening the Sternum (Sternotomy) Usually, the surgeon will perform a sternotomy. This technique consists in sawing your sternum in half vertically and in separating the two sides. This approach gives the surgeon access to your heart. Temporarily Stopping the Heart (extracorporeal circulation) Your heart will be temporarily stopped and you will be connected to a cardiopulmonary bypass pump. This device is often referred to as a heart–lung machine because it takes over their functions. Resection of the Diseased Portion of the Aorta The disease portion will be replaced with a synthetic prosthetic tube that is connected to both healthy ends of the aorta. In addition to repairing the diseased portion (aneurysm), the aortic valve will have to be repaired or replaced if it is defective. Once the procedure has been completed, your heart will be restarted. Closing the Sternum At the end of the operation, your sternum will be put back into its normal position and attached with steel wires. IMPORTANT If you have to cancel or postpone your admission. If you have a cold, the flu, a fever, or an infection the day before your surgery. Promptly call the admissions office at 819-346-1110, extension 13058. Authors Cardiopulmonary-Care Patient Program Surgical Patient Program Revision and Layout Direction des communications et des affaires publiques © Centre hospitalier universitaire de Sherbrooke (CHUS) chus.qc.ca January 2015 – 1-6-71913