How Do They Repair An Aortic Aneurysm

Intestinal aortic aneurysm repair - open

AAA - open up; Repair - aortic aneurysm - open

Open abdominal aortic aneurysm (AAA) repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The aorta is the large artery that carries blood to your belly (abdomen), pelvis, and legs.

An aortic aneurysm is when office of this artery becomes besides large or balloons outward.

Your claret vessels are the transport arrangement that carries blood to and from your heart, to the remainder of your body. Ordinarily, everything runs pretty smoothly with this organization, but sometimes there can be a trouble. For example, one of the big blood vessels that supplies claret to your abdomen and lower torso tin swell up or bulge. This bulge is called an abdominal aortic aneurysm, and information technology can be pretty serious if it breaks open, or ruptures. Let'due south talk most intestinal aortic aneurysm. This is the descending aorta, one of the large claret vessels that sends blood to your abdomen and legs. Over a menstruum of many years, this blood vessel tin can starting time to bulge. Although doctors aren't certain exactly what causes an aneurysm, they practice know that information technology's more common in males over 60 and people who are overweight, who fume, or who accept loftier blood pressure or cholesterol. Somewhen, if non treated, the aneurysm tin can pop open up or rupture, and spill blood into your abdominal cavity or into the wall of the artery. If an aneurysm ruptures, it is considered a truthful medical emergency. Then, how exercise you detect out if you have an aneurysm? You lot may not realize that you have one, because often aneurysms don't cause whatsoever symptoms until they rupture. An imaging examination similar a CT scan or ultrasound may help in finding a suspected aneurysm. If it does suspension open, you may feel astringent pain in your tum. That pain may spread to your groin, buttocks, or legs. You could also feel sick to your stomach, have clammy skin, and your heart may beat faster than normal. If yous take whatever of these symptoms, come across your doctor, who can examine y'all. Your medico may likewise recommend an imaging exam to run into for sure if y'all have an aneurysm. Treatments for aneurysms vary depending on how severe the aneurysm is. If you're non having symptoms, and your aneurysm is small and hasn't broken open, your doctor may propose just checking information technology every six months to make sure it doesn't get bigger. If it'due south bigger than 2 inches, yous'll probably need to have surgery. The goal is to perform surgery before complications and symptoms develop. The surgeon volition supplant the damaged, bulging section of claret vessel with a section of man-made vessel, ordinarily called a graft. It'southward better to avoid getting an aneurysm than to have to treat it. Eat a healthy diet, lookout your cholesterol and claret pressure levels, and quit smoking to help forestall an aneurysm from forming in the showtime place. Men who are over the historic period of 65 and have ever smoked or who have a close relative who's had an abdominal aortic aneurysm should take one screening ultrasound done to check for an abdominal aortic aneurysm. If you're having any symptoms of an abdominal aneurysm, like severe hurting in your belly or dorsum, it's very important that you get medical assist right away. Go to the emergency room or call your health care provider for immediate assistance. Pocket-size aneurysms are easy to treat with surgery. But once they get larger and rupture, they can exist life threatening.

Description

The surgery volition take identify in an operating room. You will be given general anesthesia (you will be comatose and pain-free).

Your surgeon opens up your belly and replaces the aortic aneurysm with a human being-made, cloth-like fabric.

Here is how it tin exist done:

• In one approach, you will prevarication on your back. The surgeon will make a cut in the center of your belly, from just beneath the breastbone to below the belly push. Rarely, the cut goes across the belly.
• In another approach, you will lie slightly tilted on your correct side. The surgeon volition make a 5- to half-dozen-inch (13 to xv centimeters) cutting from the left side of your belly, ending a little below your belly button.
• Your surgeon will supervene upon the aneurysm with a long tube made of homo-made (constructed) cloth. It is sewn in with stitches.
• In some cases, the ends of this tube (or graft) will be moved through blood vessels in each groin and attached to those in the leg.
• In one case the surgery is done, your legs will exist examined to make sure that in that location is a pulse. Nigh ofttimes a dye exam using 10-rays is done to confirm that in that location is good blood flow to the legs.
• The cut is closed with sutures or staples.

Surgery for aortic aneurysm replacement may take ii to iv hours. Most people recover in the intensive intendance unit (ICU) after the surgery.

Why the Procedure Is Performed

Open surgery to repair an AAA is sometimes washed as an emergency process when there is bleeding inside your body from the aneurysm.

Y'all may have an AAA that is not causing whatsoever symptoms or bug. Your wellness care provider may take establish the problem after you had an ultrasound or CT scan done for some other reason. There is a risk that this aneurysm may suddenly break open up (rupture) if yous do not accept surgery to repair it. However, surgery to repair the aneurysm may as well be risky, depending on your overall health.

You and your provider must make up one's mind whether the chance of having this surgery is smaller than the run a risk for rupture. Surgery is more likely to exist suggested if the aneurysm is:

• Larger (about two inches or 5 centimeters)
• Growing more quickly (a little less than 1/4 inch over the last 6 to 12 months)

Risks

The risks for this surgery are higher if you have:

• Heart disease
• Kidney failure
• Lung disease
• Past stroke
• Other serious medical bug

Complications are also college for older people.

Risks for whatever surgery are:

• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Center attack or stroke
• Infection, including in the lungs (pneumonia), urinary tract, and belly
• Reactions to medicines

Risks for this surgery are:

• Haemorrhage before or subsequently surgery
• Harm to a nerve, causing pain or numbness in the leg
• Impairment to your intestines or other nearby organs
• Loss of blood supply to a portion of the large intestine causing delayed bleeding in the stool
• Infection of the graft
• Injury to the ureter, the tube that carries urine from your kidneys to your float
• Kidney failure that may be permanent
• Lower sex drive or inability to get an erection
• Poor blood supply to your legs, your kidneys, or other organs
• Spinal cord injury
• Wound breaks open
• Wound infections
• Death

Before the Procedure

Your will have a concrete test and get tests earlier you have surgery.

Ever tell your provider what medicines you are taking, even drugs, supplements, or herbs yous bought without a prescription.

If y'all are a smoker, you lot should stop smoking at least 4 weeks before your surgery. Your provider can help.

During the 2 weeks before your surgery:

You will accept visits with your provider to make sure medical problems such as diabetes, loftier claret pressure, and heart or lung issues are well treated.

• You may be asked to finish taking drugs that brand information technology harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naprosyn (Aleve, Naproxen), and other drugs like these.
• Ask which drugs you should still have on the 24-hour interval of your surgery.
• Always tell your provider if yous take a cold, flu, fever, herpes breakout, or other illness before your surgery.

Exercise Non drink anything after midnight the twenty-four hours before your surgery, including water.

On the twenty-four hours of your surgery:

• Take the drugs you were told to take with a modest sip of h2o.
• Yous will exist told when to arrive at the hospital.

After the Procedure

Most people stay in the hospital for 5 to 10 days. During a hospital stay, you will:

• Exist in the intensive care unit of measurement (ICU), where you will be monitored very closely right after surgery. Yous may demand a breathing machine during the first twenty-four hours.
• Have a urinary catheter.
• Have a tube that goes through your nose into your stomach to aid bleed fluids for 1 or 2 days. You will then slowly begin drinking, then eating.
• Receive medicine to go on your blood thin.
• Be encouraged to sit down on the side of the bed and and then walk.
• Habiliment special stockings to prevent blood clots in your legs.
• Be asked to use a breathing machine to aid clear your lungs.
• Receive pain medicine into your veins or into the space that surrounds your spinal cord (epidural).

Outlook (Prognosis)

Total recovery for open surgery to repair an aortic aneurysm may take two or 3 months. Most people make a full recovery from this surgery.

Most people who have an aneurysm repaired before it breaks open (ruptures) have a proficient outlook.

References

Ramdon AR, Roddy SP, Darling C. Management of ruptured intestinal aortic aneurysms. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2022: 911-915.

Woo EY, Damrauer SM. Abdominal aortic aneurysms: open surgical treatment. In: Sidawy AN, Perler BA, eds. Rutherford'due south Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2022:chap 71.

Version Info

Terminal reviewed on: 10/30/2020

Reviewed by: Deepak Sudheendra, Doc, RPVI, FSIR, Director of DVT & Complex Venous Disease Program, Assistant Professor of Interventional Radiology & Surgery at the University of Pennsylvania Perelman School of Medicine, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, Doc, MHA, Medical Manager, Brenda Conaway, Editorial Managing director, and the A.D.A.M. Editorial team.

Source: https://www.mountsinai.org/health-library/surgery/abdominal-aortic-aneurysm-repair-open

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