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Abdominal Aortic Aneurysm Repair

What you should know

An abdominal aortic aneurysm (AAA) occurs when your aorta weakens and bulges out like a balloon. The aorta is a large blood vessel that extends from your heart to your abdomen. An aneurysm that is too big may burst and need repair. Abdominal aortic aneurysm (AAA) repair is surgery to fix an aneurysm in your abdominal aorta.


Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • During your AAA repair, you may bleed more than usual. Other organs or tissues near your aorta may be damaged, and you may get an infection. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Body organs such as your heart, kidneys, and bowels may also be damaged and may stop working. Your spinal cord may be damaged and you may become paralyzed. Your AAA could rupture during the surgery, and you could die. People who smoke, or have kidney, lung, or heart disease are at a higher risk of problems.

  • Without treatment, your AAA may grow larger. This may press on other parts of your body and cause poor blood flow and blood clot formation. Blood clots may block blood from getting to areas of your body. If this happens, it may cause the tissues of the body part to die. An AAA that keeps growing may leak blood around your aorta, other blood vessels, or into your abdomen. It may cause the AAA to burst, which is life-threatening. Call your caregiver if you are worried or have questions about your surgery, condition, or care.

Getting Ready

The week before your surgery:

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Ask your caregiver if you need to stop using aspirin, or any other prescribed or over-the-counter medicine. Ask your caregiver if you need to take antibiotics before your surgery.

  • Tell your caregiver if you had surgery on your abdomen in the past. Tell him if you have any other medical conditions, such as heart, lung, or kidney disease. Other procedures or medicines may be needed to treat your medical condition before your surgery.

  • You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.

  • You may need to have blood and urine tests done before your surgery. Imaging tests, such as x-rays, ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI), may also be done. You may also need other tests to check how your heart, lungs, and kidneys are working. Ask your caregiver for more information on other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • You may want to bring items such as a toothbrush and bathrobe. Ask your caregiver before taking any medicines on the day of your surgery. Bring all the medicines you are taking, including the pill bottles, to the hospital.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • Caregivers may put a tube through your back into your spine if you are having a TAAA repair. This tube will measure the pressure in your spinal canal. Cerebrospinal fluid (CSF) may be drained during your surgery to decrease pressure and prevent damage to your spinal cord. CSF is a clear fluid that flows around the brain and inside the spinal canal.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • You will be taken to the room where your surgery will be done. Medicine called anesthesia will be given to keep you asleep and free from pain during your surgery. Special IV lines showing how your body is doing during surgery are usually inserted after you are asleep. Your chest and abdominal area will be cleaned. Sheets will be put over you to keep the area clean. You will be placed lying on your back or on your right side. During your surgery, an incision will be made to open your abdomen. Your caregiver will carefully cut through and move muscle and other tissues away from your aneurysm.

  • A clamp will be placed on your aorta above the aneurysm to stop the blood from flowing through. Your AAA is opened and plaques such as fat and cholesterol are removed from your aortic walls. A graft will replace the weakened part of your aorta. You may have warm sheets or blankets on you during surgery to keep your body temperature normal. You may be given a blood thinning medicine to stop clots from forming inside the graft. Before your surgery is over, your caregiver will remove the clamp and check your blood flow. The incision will then be closed with stitches or staples.

After your surgery:

You will be taken to the recovery room or your hospital room, which may be in intensive care. Caregivers will check you often, and you may be on monitors that your caregivers watch outside your room. Do not get out of bed until your caregiver says it is OK. A bandage may cover your stitches or staples to keep the area clean and dry. The bandage will also help to prevent infection. A caregiver may remove the bandage soon after your surgery to check the area.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your surgery on time.

  • You have a new cough or are short of breath.

  • You have problems swallowing or your voice is hoarse.

  • You have worsening symptoms.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • Your abdomen feels hard and tight when touched, or you see bruises on the left side of your abdomen.

  • You are dizzy or have trouble staying alert or awake.

  • You can feel heartbeats in your abdomen.

  • You have blood in your bowel movements.

  • You suddenly have bad pain in your chest, neck, abdomen, back, or side. The pain may travel down to your legs, hips, and groin.

  • You urinate less than before or not at all.

  • Your feet and legs become swollen, change color, or have color patches.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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