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.
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:
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.
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.
Description of Procedure
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.
Anesthesia prevents pain during the procedure. Most people will be sore after the procedure and will be given pain medications.
Average Hospital Stay
The length of your hospital stay depends on your overall condition. Ask your doctor how long you should plan to stay.
At the Hospital
While you are recovering at the hospital, you may receive the following care:
You will be sent to the intensive care unit for monitoring.
You will have tubes in place, which may include the following:
IV—provides medications and fluids
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
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
Call your doctor if any of the following occur:
Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
Signs of infection, including fever and chills
New abdominal pain
Any change of color or sensation in your legs or feet
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.
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