The aorta is the largest artery in the body. The abdominal portion of the aorta carries blood to the abdomen, pelvis, and legs. Sometimes the walls of the aorta weaken and bulge in one area. This is called an abdominal aortic aneurysm (AAA). AAAs are most often caused by atherosclerosis, also known as hardening of arteries, and high blood pressure.
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Surgery to repair an AAA is often done when the aneurysm:
Preventive AAA surgery generally has a good outcome for people who are relatively healthy. Emergency surgery to fix an AAA rupture has a much lower survival rate, because of rapid blood loss.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Some factors that may increase the risk of complications include:
The procedure varies. It can be done before a rupture as a preventive measure or after a rupture on an emergency basis. The preventive procedure is outlined here.
Imaging or other tests may be done, including:
You may need to stop taking certain medications 1 week before surgery. Talk to your doctor about your regular medications.
Leading up to your procedure:
General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.
This may be done as an open surgery or using an endovascular approach.
In an open surgery, an incision is made from the breastbone to below the belly button. The aorta is clamped slightly above and below the aneurysm. Any blood clot on the inside of the aorta is removed. An artificial wall is used to strengthen the area. This is called a graft. The graft will be stitched to the normal aorta on either side. Then, the clamps are removed. The wound is closed with stitches.
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.
An artificial graft is stitched to the aorta.
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About 4-6 hours
Anesthesia prevents pain during the procedure. Most people will be sore after the procedure and will be given pain medications.
The length of your hospital stay depends on your overall condition. Ask your doctor how long you should plan to stay.
While you are recovering at the hospital, you may receive the following care:
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 the AAA 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 if any of the following occur:
If you think you are having an emergency, call for emergency medical services right away.
American Heart Association
Society for Vascular Surgery
Heart and Stroke Foundation of Canada
University of Ottawa Heart Institute
Abdominal aortic aneurysm (AAA). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114361/Abdominal-aortic-aneurysm-AAA. Updated January 11, 2018. Accessed March 1, 2018.
Abdominal aortic aneurysm repair. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/healthlibrary/test_procedures/cardiovascular/abdominal_aortic_aneurysm_repair_92,P08291. Accessed March 1, 2018.
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.
Hall SW. Endovascular repair of abdominal aortic aneurysms (Home Study Program). AORN Journal. 2003;77(3):630-642.
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.
7/17/2017 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114361/Abdominal-aortic-aneurysm-AAA: Reis SP, Majdalany BS, Ali F, et al. ACR Appropriateness Criteria for pulsatile abdominal mass, suspected abdominal aortic aneurysm. Available at: https://acsearch.acr.org/docs/69414/Narrative. Updated 2016.
Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 7/17/2017