Aortic Arch Replacement: Surgery Procedure, Risks, Recovery

Aortic Arch Replacement

Treatment Duration


1.5 Hours

------ To ------

2.5 Hours

Treatment Cost



------ To ------


WhatsApp Expert
Aortic Arch Replacement

Book Appointment for Aortic Arch Replacement

The aortic arch replacement is a surgical procedure that mends the heart’s intricate pathways and restores vital blood flow. The advancements in medical technology and surgical techniques have made it a highly effective treatment option for complex cardiovascular conditions.
Discover this ground-breaking procedure that restores hope and transforms outcomes. 

Aortic arch replacement uses advanced imaging and a multidisciplinary approach. This makes it a safe procedure for treating aortic arch aneurysms and restoring normal blood flow. The following blog discusses the procedure, risks, and recovery of the procedure. Read on to find out. 

Procedure Name

Aortic Arch Replacement

Conditions Treated

Aortic arch aneurysms, Aortic dissections

Benefits of the Procedure

Restoration of blood flow, Symptoms relief, Minimally invasive

Treated by

Cardiothoracic and Vascular Surgeon

You can check Aortic Arch Replacement Cost here.

What is Aortic Arch Replacement?

Aortic arch replacement is a surgical procedure that involves removing and replacing a diseased or damaged portion of the aortic arch. The aortic arch is a curved segment of the aorta located just after the ascending aorta.
It supplies oxygen-rich blood to the head, brain, neck, and arms. 

Surgical intervention may be required when there is a risk of reduced blood flow to the organs and tissues or aorta rupture.
Aortic arch replacement is a complex and highly specialised procedure that requires skilled cardiothoracic surgeons and a multidisciplinary team. 

Anatomy and Physiology of the Aorta

The aorta is the largest artery in the human body and plays a vital role in the circulatory system. It originates from the left ventricle of the heart and distributes oxygen-rich blood throughout the body.
The aorta is divided into several segments: 

  1. Aortic Root: The widest part of the aorta that attaches to the heart 

  2. Aortic Valve: It includes three flaps of tissue that open and shut to release oxygenated blood from the heart

  3. Ascending Aorta: It begins at the aortic valve and extends upwards, slightly curving to form the aortic arch.

  4. Aortic Arch: The curved segment of the aorta that gives the blood vessel its cane-like shape 

  5. Descending Aorta: The descending aorta continues down the chest and abdomen from the aortic arch.

Various arteries branch off the aorta, supplying oxygenated blood, nutrients, and hormones to internal organs and nearby supporting tissue.

Who Needs Aortic Arch Replacement?

Aortic arch surgery may be required in various situations involving the aortic arch, depending on the specific condition and its severity.
An aortic arch replacement is indicated for people who have the following:

  1. Size of the aortic arch exceeding 5.5 cm with no symptoms

  2. A growth rate of more than 0.5 cm per year without symptoms

  3. Extensive aortic arch destruction and leakage

  4. Significant plaque in the aortic arch that results in stroke

  5. Aortic arch aneurysms symptoms like hoarseness, trouble breathing, difficulty swallowing, and chest or back pain

Conditions Treated With Aortic Arch Replacement

Aortic arch replacement is primarily performed to treat conditions affecting the aortic arch.
Some of the conditions that may require aortic arch replacement include:

  1. Aortic Arch Aneurysms: They are abnormal bulges or dilations in the wall of the aortic arch.
    It may affect the blood vessels that supply blood to the head and neck.
    Aortic aneurysm repair may be necessary if the aneurysm reaches a certain size.
    It helps prevent the risk of rupture and life-threatening bleeding.

  2. Aortic Dissections: It occurs when there is a tear in the aortic wall’s inner layer.
    This causes blood to flow between the layers and compromises blood flow to vital organs. 

How is Aortic Arch Replacement Performed?

The aortic arch replacement procedure is a complex and highly specialised surgical intervention. The procedure generally takes about four hours to complete.
The general steps involved in the surgery are as follows:

  1. IV Line Administration: Patients will have an IV line inserted in their hands or arms for fluids and medications. 

  2. Anaesthesia: The anaesthesiologist will administer general anaesthesia to ensure the patient is unconscious and pain-free throughout the surgery. 

  3. Cleaning Surgical Site: The nursing team will clean the site with an antiseptic solution to prevent infections. 

  4. Median Sternotomy: The surgeon will make an incision in the chest, usually along the sternum (breastbone), to access the heart and aorta.
    The chest cavity will be opened to expose the aortic arch and surrounding structures.

  5. Cardiopulmonary Bypass: The patient will be connected to a heart-lung machine, and their heart will be stopped. This machine temporarily takes over the function of the heart and lungs.
    The surgeon can remove the diseased section and insert a replacement graft. 

  6. Cooling and Other Precautions: Since the blood circulation is stopped during the procedure, the medical team takes several precautions to avoid brain injury.
    The patient’s body temperature will be cooled to 64-82℉, reducing brain cell activity.
    This prevents injury from occurring for a short period. A specific technique known as selective antegrade cerebral perfusion may be used to ensure continuous blood flow to the brain. 

  7. Aortic Arch Replacement: The damaged segment of the aortic arch will be excised, removing any aneurysm, dissection, or diseased tissue.
    A prosthetic replacement of the aortic arch (a synthetic graft) will be sutured to replace the excised portion.
    The graft restores the continuity of the aorta, ensuring proper blood flow.

  8. Reconnection of Blood Vessels: The surgeon will attach the remaining aorta segments to the new graft. Next, they connect the blood vessels, allowing blood flow to resume through the reconstructed aortic arch.
    The patient’s blood is slowly warmed and introduced into the body. The heart is restarted, and the patient is gradually removed from the heart-lung bypass machine. 

  9. Closure: The surgeon will close the incisions in the chest and chest cavity using sutures or surgical staples. 

Depending on the nature of the aortic arch aneurysm, the surgeon may adopt an endovascular approach.
This procedure inserts a metal wire stent graft via an artery through minimally invasive techniques.

Expert Doctors

Dr. Intekhab Alam

Adult CTVS (Cardiothoracic and Vascular Surgery)

13+ Years




Dr. Ravi Kumar B L

Vascular and Endovascular Surgery

28+ Years




NABH Accredited Hospitals

Suguna Hospital, Rajajinagar

Suguna Hospital, Rajajinagar

4.8/5(89 Ratings)
Rajajinagar, Bangalore
Christian Medical College, Vellore

Christian Medical College, Vellore

4.8/5(98 Ratings)
Vellore, Vellore
Calculate Surgery Cost
Calculate Insurance Coverage

What to Expect Before and On the Day of Aortic Arch Replacement?

Aortic arch replacement is a serious operation that may require several pre-operative preparations. The doctor will provide instructions to be followed before and on the day of the procedure. 

Before Aortic Arch Replacement

The patient can expect the following before the surgery:

  1. Pre-Anaesthetic Checkup: The doctor will advise the patient for a pre-anaesthetic checkup. This will help understand the potential side effects of anaesthesia. 

  2. Consultation and Evaluation: The patient will thoroughly consult a cardiovascular surgeon. Medical history, diagnostic tests, and physical examinations are conducted to assess the condition of the aortic arch and determine the need for aortic arch replacement.
    The pre-operative diagnostic tests include:

    1. Routine blood work

    2. Chest X-ray

    3. CT scan and ultrasound

  3. Medications: The patient must inform the doctor about all their current medications. They may need to stop taking certain medicines before the surgery. 

  4. Restrictions: The patient must stop smoking for at least a month before the surgery. Smoking can affect outcomes and delay recovery. 

  5. Fasting: The healthcare team will ask the patient not to eat or drink after midnight the night before the procedure. 

  6. Discussion: The provider will briefly explain the surgical procedure, estimated cost, and duration. They will also discuss the length of hospital stay and insurance formalities. 

On the Day of the Aortic Arch Replacement

Patients can expect the following on the day of the surgery:

  1. The patient will be required to sign a consent form, giving their permission for the surgery. 

  2. They will be taken to a pre-operative room where they must change into a hospital gown and remove any piece of jewellery. 

  3. Someone from the nursing team will shave the excess hair at the surgical site. 

  4. The provider will record the patient’s last meal and give them a specific medication to be taken with water. 

  5. The anaesthesiologist will monitor the patient's vital signs, such as heart rate, breathing, and blood pressure. 

  6. The medical team will shift the patient to the OT room. 

What to Expect After Aortic Arch Replacement?

After aortic arch replacement, the patient enters the postoperative phase, which involves careful monitoring, pain management, and steps towards recovery.
Aortic arch replacement recovery usually takes about two months. It starts in the hospital and continues at home. 

The Recovery Process in the Hospital

After the surgery, the patient will spend a day or two in the ICU. In the ICU, the anaesthesiologist will monitor the patient’s vital signs.
Once their condition stabilises, they will be moved to a regular hospital room for four to five days.
While in the hospital, the patient can expect the following:

  1. A tube through the nose and stomach to drain fluids (usually removed one to three days after the surgery)

  2. A urinary catheter

  3. A breathing machine to help support the lungs

  4. Blood-thinning medications

  5. Pain medications to ease pain and discomfort

  6. Compression socks to prevent blood clots in legs

After about a week of hospital stay, the patient will get discharged. The healthcare provider will provide home care and follow-up instructions.
Since patients cannot drive for some time after surgery, they must have someone drive them home. 

Recovery Process/Expectations After Hospital Discharge

Patients can expect the following at home:

  1. Diet and Lifestyle: After surgery, individuals must eat foods rich in fibre and protein and low in fat and sugars. High-fibre foods like fruits and vegetables and drinking plenty of water can help prevent constipation.
    Furthermore, they should avoid smoking to promote healing. 

  2. Wound Care: Patients must wash the surgical area with soap and water. They must pat dry the area after showering.
    It is important to avoid applying any lotions or ointments on the surgical site for four to six weeks or until the wound heals completely.  

  3. Exercise: It is recommended to start walking as soon as possible. Patients must increase the intensity of activities as they feel stronger. 

  4. Restrictions: Individuals must avoid pushing or pulling, or heavy lifting. They should also avoid driving for four weeks or until their doctor approves. 

  5. Medicine: The doctor may prescribe pain medications for managing pain and discomfort. 

First Follow-Up Appointment

The first follow-up appointment will take place within two weeks after hospital discharge. During the visit, the patients can expect the following:

  1. The provider will remove stitches if they are not removed before discharge. 

  2. They will conduct tests to evaluate the patient’s condition. 

  3. If there are no concerns or complications, the next follow-up visit will be scheduled about four weeks after surgery.

Benefits of Aortic Arch Replacement

Aortic arch replacement surgery offers several significant benefits for individuals with conditions affecting the aortic arch. Some of the key benefits include:

  1. Restoration of Normal Blood Flow: Aortic arch replacement restores proper blood flow through the aortic arch.
    This ensures that oxygen-rich blood is effectively delivered to the head, brain, neck, and arms.

  2. Symptom Relief: Conditions affecting the aortic arch, such as aortic aneurysms, can cause various symptoms, including:

    1. Chest pain

    2. Difficulty breathing

    3. Swelling in arms or face 

Aortic arch replacement alleviates these symptoms by correcting the problem. 

  1. Potential for Minimally Invasive Technique: Traditional open-heart surgery is the standard approach for aortic arch replacement.
    However, advancements in surgical techniques have led to the development of an endovascular approach.
    These minimally invasive approaches lead to the following:

    1. Smaller incisions

    2. Reduced trauma

    3. Faster recovery

    4. Fewer complications

Risks and Complications of Aortic Arch Replacement

While aortic arch surgery, such as aortic arch replacement, can be life-saving, it carries certain risks and potential complications. It is important to be aware of these risks.
Some potential aortic arch replacement surgery risks include:

  1. Stroke: Working with the aortic arch during surgery can lead to emboli (blood clots or debris) breaking loose and travelling to the brain.
    This can lead to a stroke. 

  2. Damage to the Spinal Cord: During surgery, there is a risk of blood flow disruption to the spinal cord. It may cause spinal cord injury, leading to neurological deficits. 

  3. Bleeding: The surgery involves working on a major blood vessel. Therefore, there is a risk of significant bleeding during the procedure. 

  4. Heart Attack: The stress placed on the heart during the procedure can increase the risk of a heart attack. It can also occur due to complications like disruption in blood flow or oxygen supply to the heart muscle. 

  5. Lung or Kidney Failure: The surgery risks inadequate blood flow to organs and tissues, which can result in organ dysfunction.
    It particularly affects the lungs and kidneys.

  6. Bowel Necrosis: Inadequate blood flow to the intestines or impairment of the abdominal circulation can result in tissue death in the bowel. 

  7. Death: Aortic arch replacement is a major operation with inherent risks. Sometimes, despite the best efforts of the surgical team, there is a risk to life.
    The aortic arch replacement mortality rate in hospitals is about 10.9%.

When to See a Doctor?

It is always better to seek medical attention if patients have concerns or their symptoms worsen. After aortic arch replacement, patients should promptly contact their doctor if they experience the following:

  1. Excessive drainage or bleeding from the incision site

  2. Redness, swelling, or excessive pain at the surgical site

  3. Fever above 100℉ for over 24 hours

  4. Persistent swelling in hands or feet

  5. Sudden fluctuations in weight 

  6. Irregular or rapid heartbeat

  7. Shortness of breath or difficulty breathing after daily activities

Risks of Delaying Aortic Arch Replacement

Delaying aortic arch replacement can worsen an individual’s condition and pose several risks. Some risks associated with delaying the procedure include:

  1. Aortic Rupture: Aortic arch aneurysms can cause an aortic rupture if left untreated. A complete tear or hole in all three aorta layers leads to life-threatening bleeding.
    Delaying surgery can increase the risk of aortic rupture. 

  2. Progression of Aortic Dissection: Aortic dissection is a life-threatening condition that requires immediate treatment.
    Delay in surgery can worsen the dissection, ripping the outer aorta layer and allowing blood to escape the artery. If not treated quickly, it can cause sudden death.

Cost of Aortic Arch Replacement

The total cost of aortic arch replacement can range from ₹ 1,70,000 to ₹ 2,50,000. The cost of aortic arch replacement surgery can be influenced by several factors, including:

  1. Hospital and facility fees

  2. Surgeon’s fees

  3. Anaesthesia cost

  4. Pre-operative tests and evaluations

  5. Surgical approach and complexity of the procedure

  6. Length of hospital stay

  7. Post-operative care

  8. City or location

  9. Insurance coverage

Surgery Name

Surgery Cost

Aortic Arch Replacement

₹ 1,70,000 to ₹ 2,50,000


Aortic arch replacement is a critical surgical intervention that restores blood flow and prevents complications. It offers the potential for improved cardiovascular health for those with aortic arch conditions. Timely evaluation and care can make all the difference in ensuring a healthier future.

Are you or your loved ones looking to undergo aortic arch surgery? Get in touch with the HexaHealth team! We provide comprehensive support and guidance throughout the journey of aortic arch replacement. With a multidisciplinary approach and personalised care, our team ensures you receive the highest medical expertise and comfort during this complex procedure.

Suggested Reads

Aortic Valve Replacement Heart Valve Replacement
Heart Transplant Pulmonary Valve Implantation

Frequently Asked Questions (FAQ)

Aortic arch replacement surgery is a procedure that involves removing and replacing a damaged or diseased portion of the aortic arch.
Replacing this curved segment of the aorta helps restore normal blood flow and prevent complications.


An aortic arch aneurysm is an abnormal bulge or dilation in the aortic arch. It poses a risk of rupture and can lead to life-threatening bleeding if left untreated.


Aortic aneurysm repair is typically performed through open surgery or endovascular repair. In open surgery, a section of the enlarged aorta is replaced with a synthetic graft.
Endovascular repair involves inserting a stent graft through small incisions.


Aortic arch replacement surgery generally involves the following steps: 

  1. Making an incision in the chest

  2. Placing the patient on cardiopulmonary bypass

  3. Cooling the body temperature

  4. Replacing the damaged portion of the aortic arch with a synthetic graft to restore normal blood flow

  5. Restarting the heart

  6. Closing the incisions and chest cavity with sutures


Aortic arch surgery is indicated in cases of aortic arch aneurysms, aortic dissections, or other aortic arch conditions causing significant compromise to blood flow.
It may be indicated for people with the following:

  1. Aortic arch size exceeding 5.5 cm

  2. The aortic arch growth rate of more than 0.5 cm per year without symptoms

  3. Extensive aortic arch destruction 

  4. Significant plaque in the aortic arch 

  5. Symptoms like hoarseness, trouble breathing, difficulty swallowing, and chest or back pain


Common symptoms that may indicate the need for aortic arch replacement surgery include:

  1. Chest pain

  2. Shortness of breath

  3. Difficulty swallowing

  4. Hoarseness

  5. Arm or leg weakness

  6. Symptoms of reduced blood flow to the head, neck, or brain.


Yes, aortic arch replacement can be performed with minimally invasive techniques. These techniques include smaller incisions, shorter hospital stays, and quick recovery.
However, adopting a minimally invasive approach may not be possible in every case.


Yes, pre-operative tests are performed before aortic arch replacement surgery to assess the patient’s overall health and determine the surgical approach. These may include:

  1. Blood tests

  2. Imaging scans (such as CT or MRI)

  3. Chest X-ray

  4. Electrocardiogram (ECG)

  5. Echocardiogram


The duration of aortic arch replacement surgery can vary based on factors like the complexity of the case, the surgical approach, and any associated procedures.
Generally, the procedure takes about four hours 12 to complete.


Yes, alternative treatment options to aortic arch replacement surgery are available. These may include endovascular procedures such as stent placement or hybrid approaches combining surgery and endovascular techniques.


Generally, success rates of aortic arch replacement range from 91% to 100% with appropriate patient selection and experienced surgeons.
The success rate varies depending on multiple factors, including:

  1. Patient’s overall health

  2. The complexity of the case

  3. Type of graft used

  4. The expertise of the surgical team


The anaesthesiologist usually administers general anaesthesia during aortic arch replacement surgery. This ensures the patient is completely unconscious and pain-free.


The duration of hospital stay after aortic arch replacement surgery varies depending on the patient’s overall health, the procedure’s complexity, and the recovery rate.
The hospital stay generally lasts for a week. Patients spent one to two days in the ICU and about four to five days in a regular room.


The long-term prognosis after aortic arch replacement surgery is generally positive, with improved survival rates and a reduced risk of complications.
The estimated 5-year survival after open aortic arch surgery is 81%. This makes it a reliable cardiac surgical procedure.


During aortic arch replacement recovery, patients can expect a period of close monitoring in the intensive care unit.
They can expect wound care, pain management, exercise, and a gradual return to normal activities at home. The exact recovery process varies for each individual.


The timeline for returning to normal activities after aortic arch replacement surgery varies for each patient. It typically takes about two months to recover fully and gradually return to normal activities.


After aortic arch replacement surgery, patients may be advised to adhere to a heart-healthy diet (low in sodium, fat, and cholesterol) to promote cardiovascular health. Lifestyle changes may include:

  1. Quitting smoking

  2. Regular exercise

  3. Stress management


The cost of aortic arch replacement ranges between ₹ 1,70,000 to ₹ 2,50,000. However, it can vary significantly depending on factors such as:

  1. The city or location

  2. Type of hospital

  3. Surgeon's fees

  4. Anaesthesia

  5. Preoperative tests

  6. Length of hospital stay

  7. Postoperative care

It is best to consult with healthcare providers or hospitals to obtain specific cost information.


Ascending aortic replacement involves replacing the diseased or damaged portion of the ascending aorta (the first segment of the aorta that emerges from the heart).
Aortic arch replacement replaces the aortic arch (the curved segment of the aorta located after the ascending aorta).


Following aortic arch replacement surgery, specific postoperative care instructions may include:

  1. Adopting a heart-healthy lifestyle

  2. Monitoring for complications

  3. Managing pain and wound care

  4. Taking prescribed medications

  5. Gradually resuming physical activity

  6. Attending follow-up appointments


Aortic arch replacement surgery carries various risks, depending on the complexity of the surgery. These risks include: 

  1. Bleeding

  2. Stroke

  3. Spinal cord injury

  4. Heart attacks

  5. Lung or kidney failure

  6. Bowel necrosis 

  7. Potential for mortality


Potential long-term complications after aortic arch replacement surgery can include:

  1. Infection or rupture

  2. Recurrent aneurysms 

  3. Neurological deficits

  4. Need for additional surgical interventions


Generally, the aortic arch replacement mortality rate is about 10.9%. However, the mortality rate varies depending on several factors, including:

  1. Patient characteristics

  2. Underlying conditions

  3. The complexity of the procedure


Myth: Aortic arch replacement always requires open-heart surgery. 

Fact: Traditional open-heart surgery with a large incision is the common approach for aortic arch replacement.
However, minimally invasive procedures are also available. These techniques involve smaller incisions, shorter hospital stays, and faster recovery. 



All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.

  1. Cleveland Clinic. The Aorta | Cleveland Clinic [Internet]. Cleveland Clinic.
  2. Aortic Arch Replacement | Cardiothoracic Surgery | Loyola Medicine [Internet]. [cited 2023 Jul 21].link
  3. Tian DH, Croce B, Ashutosh Hardikar. Aortic arch surgery. 2013 Mar 1 [cited 2023 Jul 21];link
  4. Aortic Arch Surgery [Internet]. Sydney Heart and Lung. [cited 2023 Jul 21].link
  5. [cited 2023 Jul 21].link
  6. Aortic Root Replacement Surgery [Internet]. Cleveland
  7. Sanphasitvong V, Wongkornrat W, Jantarawan T, Khongchu N, Slisatkorn W. Mortality and complications following total aortic arch replacement: 14 years’ experience. Asian Cardiovascular & Thoracic Annals [Internet]. 2022 Jul 1 [cited 2023 Jul 21];30(6):679–
  8. Cleveland Clinic. Aortic Dissection | Cleveland Clinic [Internet]. Cleveland Clinic.
  9. Vessel Plus [Internet]. [cited 2023 Jul 21].link
  10. Radosław Gocoł, Bis J, Hudziak D, Piekarska M, Łukasz Morkisz, Deja MA. Open aortic arch surgery: 10 years’ single-center experience. 2021 Jan 1 [cited 2023 Jul 21];link


Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More


Sangeeta Sharma

Sangeeta Sharma

BSc. Biochemistry I MSc. Biochemistry (Oxford College Bangalore)

6 Years Experience

She has extensive experience in content and regulatory writing with reputed organisations like Sun Pharmaceuticals and Innodata. Skilled in SEO and passionate about creating informative and engaging medical conten...View More

Book Appointment for Aortic Arch Replacement

get the app
get the app