Definition
Abdominal aortic aneurysm (AAA) repair is surgery to fix a bulge in the lower aorta. The bulge is called an aneurysm. The aorta is the largest artery in the body. The abdominal part of the aorta carries blood to the abdomen, pelvis, and legs.
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Reasons for Procedure
AAA repair is often done when the aneurysm:
- Causes symptoms such as belly pain
- Gets too big
- Has burst—which causes life-threatening bleeding
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia
- Infection
- Injury to nearby structures or organs
- Death
AAA surgery for prevention tends to have better outcomes. Emergency AAA surgery has a lower survival rate. This is due to quick blood loss.
Things that may raise the risk of problems are:
- Smoking
- Drinking alcohol
- Long-term diseases such as lung disease, heart disease, diabetes, or obesity
- Previous transient ischemic attack (TIA) or stroke
What to Expect
The procedure varies. It can be done before a burst—to prevent problems. It can also be done after a burst—as emergency treatment. The preventive procedure is outlined here.
Prior to Procedure
The surgical team may meet with you to talk about
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery
Anesthesia
The doctor will give you general anesthesia. You will be asleep.
Description of Procedure
The surgery may be done one of two ways:
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 inside 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. A bandage will be placed over the site.
Endovascular Repair
A small incision is made in the leg. A stent will be inserted in this incision and into the aorta. It will be moved to the aneurysm. The stent will take pressure off the aorta wall. This will prevent it from bulging or leaking. The incision will then be closed. A bandage will be placed over the site.
An artificial graft is stitched to the aorta.
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How Long Will It Take?
About 4 to 6 hours
Will It Hurt?
Soreness is common after the procedure. Medicine and home care help.
Average Hospital Stay
The length of the stay varies. It depends on a person's overall health.
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Give medicines to control pain or nausea
- Give IV fluids and medicine
- Place a tube through the nose and into the stomach—to remove secretions and provide nutrition as your intestines get back to normal
During your stay, the hospital staff will take steps to lower your risk of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Recovery takes about 6 weeks. Physical activity will be limited during this time.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excess bleeding, or discharge at the incision
- Pain you cannot control with the medicine
- Any change of color or feeling in your legs or feet
- Belly cramps, loose stools (poop), or problems passing urine
- Lasting nausea or vomiting
- Cough, problems breathing, or chest pain
- Unusual tiredness, low mood, or confusion
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Heart Association
http://www.heart.org
Society for Vascular Surgery
https://vascular.org
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca
University of Ottawa Heart Institute
https://www.ottawaheart.ca
REFERENCES:
Abdominal aortic aneurysm (AAA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/abdominal-aortic-aneurysm-aaa. Accessed August 25, 2021.
Abdominal aortic aneurysm repair. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/abdominal-aortic-aneurysm/abdominal-aortic-aneurysm-repair. Accessed August 25, 2021.
Aneurysm repair. The Texas Heart Institute website. Available at: https://www.texasheart.org/heart-health/heart-information-center/topics/aneurysm-repair/. Accessed August 25, 2021.
Mei F, Hu K, et al. Retroperitoneal versus transperitoneal approach for elective open abdominal aortic aneurysm repair. Cochrane Database Syst Rev. 2021 Jun 21;6(6):CD010373.
Last reviewed July 2021 by EBSCO Medical Review Board Nicole Meregian, PA Last Updated: 8/25/2021