Abdominal Aortic Aneurysm Repair (AAA)

Emergency surgery due to a burst aneurysm Severe hemorrhage Low blood pressure Shock Cardiovascular disease, including angina or a previous heart attack Cerebrovascular disease, including previous episodes of transient ischemic attacks Pre-existing lung disease Debilitation due to cancer Diabetes Obesity What to Expect The procedure varies. It can be done before a rupture (preventive) or after a rupture (emergency). The preventive procedure is outlined here. Prior to Procedure Your doctor will likely do some or all of the following: CT scana type of x-ray that uses a computer to make pictures of structures inside the abdomen MRI scana test that uses magnetic waves to make pictures of structures inside the abdomen Abdominal ultrasound Electrocardiogram (ECG, EKG)a test that records the heart's activity by measuring electrical currents through the heart muscle Chest x-ray On the day of the surgery, you will be given an antibiotic intravenously (in the vein). You may also be given a laxative or enema to clear the colon. Anesthesia General anesthesia Description of the Procedure An incision is made from the breastbone to below the belly button. The doctor clamps the aorta slightly above and below the aneurysm. The blood clot on the inside is removed. The aneurysm is removed. An artificial graft made of Dacron is stitched to the normal aorta on either side of where the aneurysm had been. Then the clamps are removed. The wound is closed with stitches.

After Procedure You will be sent to the intensive care unit for monitoring. You will have catheters in place, including the following: Urinary cathetermonitors urine output Arterial cathetermonitors blood pressure Central venous cathetermonitors pressure in the heart Epidural catheterprovides pain medication Nasogastric tubeinserted through the nose and into the stomach to remove secretions and provide nutrition until your intestines regain normal function How Long Will It Take? 4-6 hours Will It Hurt? Anesthesia prevents pain during the procedure. Possible Complications There is risk with any surgery. Infection, bleeding, or problems from general anesthesia can occur. Excessive bleeding Injury to the ureters Kidney failure Decreased blood supply to the spinal cord Death Average Hospital Stay This varies and will be determined by your doctor. Postoperative Care After surgery, you may gradually return to normal activities. You will need to manage any risk factors or conditions to prevent further problems. Atherosclerosis and high blood pressure should be managed with medications and a healthful lifestyle. Outcome

Preventive AAA surgery generally has a good outcome for people who are relatively healthy. Emergency surgery to fix an AAA rupture has a 50% survival rate, due to the rapid loss of blood. Call Your Doctor If Any of the Following Occurs Signs of infection, including fever and chills Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site Cough, shortness of breath, chest pain, or severe nausea or vomiting Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine RESOURCES: American Heart Association www.americanheart.org/ National Heart, Lung, and Blood Institute, NIH http://www.nhlbi.nih.gov/ CANADIAN RESOURCES: Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/ University of Ottawa Heart Institute http://www.ottawaheart.ca/ References: Aneurysm, aortic. American Heart Association Web site. Available at: http://www.americanheart.org. Accessed June 3, 2008. Medical encyclopedia: abdominal aortic aneurysm. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000162.htm. Accessed June 3, 2008. Last reviewed November 2007 by J. Peter Oettgen, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.