Why is this procedure done?
The aorta is the largest blood vessel in the body. It carries oxygen rich blood from the heart to the rest of the body. The walls of this blood vessel are thick. In some cases the walls may become weak. A bulge or pouch may form along the walls of the aorta. If it is in the area of your belly, it is an abdominal aortic aneurysm. If the area is in your chest, it is a thoracic aortic aneurysm. � �
A repair is done: � �
- To keep the weak spot in your aorta from bursting
- So the aneurysm does not get bigger
- To keep a good blood flow to the belly and lower body and legs
- If the size of the swollen blood vessel is close to 5 centimeters or 2 inches or more
- If your aneurysm is bleeding. Sometimes, the wall of the blood vessel is so weak it bursts or starts leaking slowly. The doctor will need to fix this right away in surgery so the bleeding can be stopped.
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What will the results be?
Planned surgery is safer than emergency surgery. It is good to fix the aneurysm in a planned surgery. If not, you risk it bursting. You may be stopping serious side effects of your illness by having surgery. Your aneurysm will be removed or repaired. You will have better blood flow to the belly and legs after surgery. Talk to your doctor about the likely results of this procedure. � �
What happens before the procedure?
- Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin � �, ibuprofen, Aleve � � (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- You may be given a dye called "contrast " � for this procedure. Tell your doctor if you are allergic to dye or shellfish.
Your doctor will do an exam and may order: � �
- Lab tests
- CT scan
- Sometimes, x-rays of the blood vessels of your belly and legs will be done. These will check how the blood flows in the legs and belly. You may need to have a separate procedure in the x-ray or heart cath center at the hospital before you have the aneurysm fixed.
What happens during the procedure?
- Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs. A special I.V., called a central line, will be placed in your neck. Other I.V.s may be put in to measure your blood pressure in a special way while you are in surgery.
- When you are asleep, the doctors may put a tube in your mouth to help you breathe. They may also put another small tube in your nose. This one goes down to your stomach to drain out any food or fluid that might come out during surgery. You will have a tube in your bladder to drain urine.
- Your doctor can do the surgery one of two ways.
- Open aortic aneurysm � � � The doctor will make a cut in your belly or chest. Clamps will be put on the big blood vessel above and below the site of the swollen part. This will stop the blood from flowing out when the surgeon makes a cut. The swollen part of the blood vessel will be cut and replaced with a tube called a graft. This tube will join both ends of your aorta. The clamp will then be removed.
- Endovascular aortic repair (EVAR or ELG) � � � You may or may not be fully asleep. You will be given drugs that make you groggy and relaxed, but you may be aware of what is happening around you. You will be lying on your back during the procedure. Your doctor will give you drugs to numb the part where the procedure is to be done. The doctor makes a small cut in your groin. Then, the doctor puts a needle into the vessel in your thigh. This is your femoral artery. The doctor use special tools to reach the swollen part of the blood vessel. Your doctor will put in a contrast dye to see where the swollen part is. Then, a small tube or graft will be put in your femoral artery. The doctor will move it up to the swollen part in your aorta. Your cut will be stitched and dressings will be put on.
- The procedure takes 2 to 4 hours.
What happens after the procedure?
- You will go to the Intensive Care Unit (ICU) to recover after surgery. You may still have machines and tubes connected to you. These may include a heart monitor and tube to drain your urine. You may still have a tube in your mouth to help you breathe.
- The staff will take out your breathing tube when you are awake and strong enough to breathe. You may have a sore throat afterwards. The other tubes and wires will all be taken out in a few days. You will wear tight socks on your legs to help increase blood flow.
- Within a day or two, you will get out of bed to a chair. The staff will help you start to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear. You will get drugs to help with your pain.
- You may need to have a blood transfusion after surgery.
- Your doctor will move you to a regular hospital room when you are stable.
- You will need to stay in the hospital for 3 to 7 days after surgery.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
What problems could happen?
- Infection
- Bleeding
- Blood clots
- Organ damage
Where can I learn more?
National Heart Lung and Blood Institute � �
http://www.nhlbi.nih.gov/health/health-topics/topics/arm/ � �
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This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. � �
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