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.
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.
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.