I'm not a doctor. I am a survivor of a Type A-1 aortic dissection repaired by open heart surgery in 2015. Think of your aorta as more or less a big candy cane coming off of the top of your heart. My aorta dissected, meaning that split, at the top of that candy cane coming out of my heart. In actuality, your aorta is made up of three layers of tissue. A the section generally occurs when the layers of that tissue are separated and blood flows through that separation, forcing the dissection down the aorta until it either stops or it dissects entirely. It is incredibly painful. I can assure you, you do not ever want to happen to you. It was simply the most excruciating pain I've ever been in in my life.

In answer to your question, there really isn't any way to repair an ascending aorta without cracking your chest open (YET). There is a lot of medical research going on and I suspect at some point in the future, they will have a way to go in and make this repair robotically in some cases. But, at the end of the day you're trying to fix a beating heart with several liters of blood flowing through it every minute and you need good clear and open access to be able to see what you're doing and what needs to be fixed. When I had my surgery, I was left in a coma for a couple of weeks because the sutures between my heart and the artificial aorta that they implanted in me were leaking blood. I'm not sure precisely how you would propose to robotically get inside my chest to address that bleeding problem. The way it was addressed for me is that they left me in a coma and left my chest open until they were satisfied that I was no longer bleeding from where the aortic graft had been installed. The aortic graft looks like a small vacuum hose, which is flexible and made of Dacron nylon and is 13 inches long and and 1.25" in diameter. My graft was made by a company called WL Gore, which is the same company that makes Goretex waterproof, clothing and boots. I thank them every day for being alive.

As much as I love technology, and as much as I believe in the future of artificial intelligence, I do think there are some physical limits for how certain things can be repaired. Mechanically, your aorta is about 1 1/2 times the size of a garden hose. Your body needs to be put on a cardio bypass machine and/or ECMO in order to continue your blood flow while your aorta is repaired and keep you alive. Every drop of your blood passes through your aorta and goes on through the rest of your vasculature to provide oxygenated blood throughout your body. By analogy, your aorta is the main highway within your body with auxiliary, roadways trails, and paths off of it. In order to effectively get to where you need to go, a surgeon needs to do a median sternotomy, which is a medical term for cracking your chest open.

On the other hand, if you have an abdominal aortic aneurysm, which is further down the aortic trunk toward your stomach, there are some newer techniques that allow doctors to go in endovascularly and do a thing called an elephant trunk repair. That's basically where they go through a small cut in your femoral artery in your thigh and then feed up a large Dacron stent and deploy it without stopping your heart. That's possible today without the sternotomy for abdominal aortic aneurysms (AAA). You MIGHT be able to repair a AAA without massive surgery, but the doctors are still going to be going in through the groin.

Nature has essentially given all of us a protective shell over the top of a very important organ, namely the heart which is protected by the sternum and a rib cage. This protective shell is great when we're trying to protect our vital organs behind it, but it gets in the way of a surgeon who needs to access those organs to make repairs. The sterum needs to be opened up and retracted in order for a doctor to repair our hearts.

Lastly, I don't know whether or not there were any doctors on this blog. I doubt it, but their input is welcome. Peace.