Aortic Aneurysm Repair
The aorta is the largest artery in the body. It begins at the heart and runs through the chest and abdomen. Sometimes the walls of the aorta weaken and bulge in one area. An aortic repair is a surgery to create a support for the weakened area.
Reasons for Procedure
This procedure is done to:
- Prevent an aneurysm from rupturing/bursting, which causes severe, life-threatening bleeding
- Remove a ruptured aneurysm and repair the damaged aorta
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Problems from general anesthesia such as lightheadedness, low blood pressure, and wheezing
- Blood clots
- Damage to organs or tissue
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor will likely do some or all of the following:
- Physical exam
- Blood tests
- Imaging tests may be done, including:
- Cardiac catheterization
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure
Leading up to your procedure:
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be given laxatives and/or an enema to empty your intestines.
- You may be asked to shower the morning of your procedure. You may be given special antibacterial soap to use.
- Arrange for help at home after returning from the hospital.
- Arrange for a ride to and from the procedure.
General anesthesia will be used. You will be asleep.
Description of Procedure
Depending on the location of the aneurysm, blood flow may need to be passed to a heart-lung machine. The machine will temporarily do the jobs of the heart and lungs.
This may be done as an open surgery or using an endovascular approach.
During an open surgery, an incision will be made over the area of the aneurysm. This may be in the abdomen or chest. The aorta will be clamped off above and below the aneurysm. The aneurysm will be opened and cleaned of any debris. The graft will be sewn into place to reconnect the 2 ends of the aorta. The tissue of the aneurysm will then be wrapped around the outside of the graft.
When the graft is properly in place, the clamps will be released. This will allow blood flow to resume through the aorta. The incision will be closed, using either stitches or staples. The area will be covered with a sterile dressing.
For the endovascular repair, a small incision will be made in your leg. A sleeve will be inserted in this incision and into the aorta. It will be advanced to the aneurysm. The sleeve will take pressure off the wall and prevent it from expanding or leaking. The incision will then be closed.
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Immediately After Procedure
You will be brought to a recovery room after surgery. You will be monitored there for any negative effects from the surgery or anesthesia.
How Long Will It Take?
One to a few hours
How Much Will It Hurt?
Anesthesia prevents pain during surgery. The incision will cause some pain after the surgery. Talk to your doctor about medications to help you manage the pain.
Average Hospital Stay
The usual length of stay is 4-7 days. Your doctor may choose to keep you longer if complications occur.
At the Hospital
- You will need to stay in the intensive care unit for the first day or so after surgery. You will then be moved to a regular hospital room.
- For the first day or 2, you will be hooked up to monitors to track your heart rate, breathing, blood pressure, and blood oxygen levels. Your doctor may also order blood tests, chest x-rays, ECG, and an ultrasound of the repaired area of the aorta.
You may have some tubes in place, which may include the following:
- IV—delivers fluids and medication
- Urinary catheter—monitors urine output
- Arterial catheter—monitors blood pressure
- Central venous catheter—monitors pressure in the heart
- Epidural catheter—provides pain medication
- Nasogastric tube—inserted through the nose and into the stomach to remove secretions and provide nutrition until your intestines regain normal function
- You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will help improve lung function after general anesthesia.
- You may be given special compression stockings to wear after surgery. They may help decrease the possibility of blood clots forming in your legs.
To help prevent further problems, you and your doctor will need to work to increase your overall health. This can be done with medications and a healthy lifestyle. If you are a smoker, you should talk to your doctor about quitting.
Recovery takes about 6 weeks. If you had symptoms from your aneurysm before the surgery, you may notice some improvements in your health. You may find you have more strength and less swelling in your legs. You may also have lower blood pressure, improved energy, and absence of pain from the aneurysm.
Call Your Doctor
Call your doctor if any of the following occur:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Pain or swelling in your abdomen
- Persistent nausea or vominting
- Pain that you cannot control with the medications you were given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Cough, shortness of breath, or chest pain
- Pain or swelling in your feet, calves, or legs
If you think you are having an emergency, call for emergency medical services right away.
American Heart Association
The Society of Thoracic Surgeons
Heart and Stroke Foundation of Canada
University of Ottawa Heart Institute
Aneurysm repair. The Texas Heart Institute website. Available at: https://www.texasheart.org/heart-health/heart-information-center/topics/aneurysm-repair. Accessed March 1, 2018.
Aortic aneurysm repair. Encyclopedia of surgery website. Available at: http://www.surgeryencyclopedia.com/A-Ce/Aortic-Aneurysm-Repair.html. Accessed March 1, 2018.
Thoracic aortic aneurysm. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T908572/Thoracic-aortic-aneurysm. Updated June 1, 2018. Accessed March 1, 2018.
6/2/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 5/2/2014