What is abdominal aortic aneurysm surgery?

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Abdominal aortic aneurysm surgery: Overview

Open surgery is done to repair an abdominal aortic aneurysm. It is called an open surgery because the abdomen is opened so the doctor can see and work on the aorta.

Your aorta is a large artery that carries blood from your heart through your belly to the rest of your body.

To do the surgery, the doctor makes a large cut (incision) in your belly or side. The doctor replaces the weak and bulging section of the aorta with a man-made tube (called a graft). General anesthesia is used for this surgery.

You may spend several days in the hospital. You will need to take it easy for at least 4 to 6 weeks at home.

What happens on the day of your abdominal aortic aneurysm surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You may get an epidural catheter, which is a tiny tube that puts pain medicine into the area in your back around your spinal cord. The epidural will prevent pain after surgery.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 2 to 3 hours.
  • You will be encouraged to get out of bed the day after surgery. You will have lots of help doing this.
  • Your doctor will have you do breathing exercises. These help to keep your lungs healthy.

How well does abdominal aortic aneurysm surgery work?

When an aortic aneurysm is at risk of rupturing, or bursting open, the benefits of repairing the aneurysm can outweigh the risks. Repairing the aneurysm lowers the risk of rupture. And the repair can help a person live longer. Repairing a smaller aneurysm, which doesn't have as high a risk of rupture, does not help a person live longer.

How do you prepare for abdominal aortic aneurysm surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What are the risks of abdominal aortic aneurysm surgery?

Most people who have open repair surgery recover well. But this surgery has serious risks during surgery and soon after surgery.

About 5 out of 100 people die during surgery or within 30 days. This risk may depend on your health before surgery and where the aneurysm is located.

About 9 to 17 out of 100 people have complications during the surgery or within 30 days. These complications include problems with the heart, kidneys, or lungs.

Complications after the surgery include bleeding, infection, colon problems, and problems with the repaired aneurysm.

What can you expect as you recover from abdominal aortic aneurysm surgery?

You will stay in the hospital for a few days to recover.

You can expect the cut (incision) to be sore for a few weeks. You will feel more tired than usual for several weeks after surgery. You may be able to do many of your usual activities after 4 to 6 weeks. But you will probably need 2 to 3 months to fully recover.

You will have follow-up visits with your doctor to check on your recovery. Then, you will likely have annual checkups. You might have a test, such as a CT scan or ultrasound, every few years to check your repaired aorta.

Be sure to tell your dentist and doctors that you have the graft in your aorta. This is important because you may need to take antibiotics before certain procedures to prevent an infection.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood or foamy, pink mucus.
  • You have severe pain in your belly.
  • You have chest pain or pressure. This may occur with:
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms.
    • Dizziness or lightheadedness.
    • A fast or uneven pulse.
    After calling 911, chew 1 adult-strength aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor now or seek immediate medical care if:

  • You have new or increased shortness of breath.
  • You are dizzy or lightheaded, or you feel like you may faint.
  • You are sick to your stomach or cannot keep fluids down.
  • You have pain that does not get better after you take pain medicine.
  • You have a fever over 100°F.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.

Watch closely for any changes in your health, and be sure to contact your doctor if:

  • You have sudden weight gain, such as 3 pounds or more in 2 to 3 days.
  • You have increased swelling in your legs, ankles, or feet.
  • You have any concerns about your incision.

After abdominal aortic aneurysm surgery: Overview

Aortic aneurysm repair is surgery to fix a weak and bulging section of the aorta. The aorta is the large blood vessel (artery) that carries blood from the heart through the belly to the rest of the body. The doctor used a man-made tube, called a graft, to replace the weak section of your aorta in your belly.

You can expect the cut (incision) to be sore for a few weeks. The doctor will take the stitches out of your incision about 5 to 10 days after surgery.

You will feel more tired than usual for several weeks after surgery. You may be able to do many of your usual activities after 4 to 6 weeks. But you will probably need 2 to 3 months to fully recover.

For 6 weeks, it is important to avoid strenuous activity and heavy lifting. These activities will not hurt the graft in your aorta. But they may cause problems with the incision in your belly.

Some people find that they feel sad or more emotional than usual while they are recovering after this surgery. This may last for up to 6 weeks after surgery. Talk with your doctor if your sadness continues or if you have concerns about how you are feeling. Treatment and other support can help you feel better.

Be sure to tell your dentist and doctors that you have the graft. This is important because you may need to take antibiotics before certain procedures to prevent an infection.

You might have a test, such as an ultrasound or CT scan, every few years to check your repaired aorta.

How is abdominal aortic aneurysm surgery done?

General anesthesia is used for this surgery. To do the surgery, the doctor makes a large cut (incision) in your belly or side. Then the doctor puts clamps above and below the weak part of the aorta. This stops blood flow. It allows the doctor to replace the weak part of the aorta with a man-made tube called a graft.

After the graft is in place, the doctor removes the clamps so blood can flow again. Then the doctor uses stitches or staples to close the incision.

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