Endovascular Abdominal Aortic Aneurysm Repair

WHAT YOU SHOULD KNOW:

Abdominal aortic aneurysm (AAA) repair is surgery to fix an aneurysm in your abdominal aorta. An 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.


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:

  • You may bleed more than expected during surgery, get an infection, or have trouble breathing. The arteries where the catheters were put may be damaged. Your groin may be bruised. The surgery may cause blood clots or air bubbles in your blood. These could cause a stroke or a heart attack. Organs such as your kidneys, lungs, and liver may be damaged and stop working. Your AAA could break open during surgery. If caregivers cannot fix your AAA with this surgery, they may need to do open surgery.

  • Even after this surgery, your AAA may grow over time. Blood may leak between the graft and the AAA. This may make the AAA grow weaker and larger. It may even cause the AAA to rupture and be life-threatening. The stent may move out of place, break, or bend and block blood flow. You may get leaks between your aorta and other blood vessels or into your abdomen.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

Monitoring:

  • Arterial line: An arterial line is a tube that is placed into an artery (blood vessel), usually in the wrist or groin. The groin is the area where your abdomen meets your upper leg. An arterial line may be used for measuring your blood pressure or for taking blood.

  • Central venous line: A central line is an IV catheter or tube. It is put into a large vein (blood vessel) near your collarbone, in your neck, or in your groin. You may need a central line to receive medicines or IV fluids, or to have blood samples taken. The central line may be used to help caregivers monitor your condition during and after surgery.

Pre-op care:

You will lie on a hard movable x-ray bed. You may be given medicine in your IV to help you relax. The hair in this area may also need to be removed. You will receive anesthesia:

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Local or monitored anesthesia: Anesthesia is medicine that keeps you from feeling pain during surgery or a procedure. Local anesthesia is a shot of numbing medicine put into the skin where you will have surgery. You will be fully awake during the surgery or procedure. You may feel pressure or pushing, but you will not feel pain. Monitored anesthesia means you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the surgery or procedure.

  • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

During your surgery:

Caregivers will make an incision on each side of your groin. A sheath (long hollow tube) is put through your skin and into the artery (blood vessel) inside the groin. The sheath allows caregivers to insert different catheters into the artery during the surgery. A catheter with a stent graft (mesh tube) is threaded through the sheath and into your AAA. Your caregiver will do x-rays or other tests to take pictures of your AAA and graft during the surgery. Dye is injected through a catheter so that your AAA and graft show up better in the pictures. The stent graft is flat while caregivers thread it into the AAA. Once inside the AAA, the stent graft is opened up with a balloon-tipped catheter.

After surgery:

Tight pressure bandages will be put over the arteries of your groin. Your vital signs will be checked and caregivers will check your bandages often for bleeding. Tell caregivers if you feel warmth or wetness in your groin area. This may mean an artery is still bleeding.

  • Activity: Lie in bed and keep your legs straight. Do not get out of bed until your caregivers say it is okay. When you may get up, ask someone to walk with you in case you feel weak or dizzy.

  • Deep breathing and coughing: Deep breathing opens the tubes going to your lungs, and helps prevent a lung infection. Do deep breathing, and do several small coughs every hour while you are awake. Also do this if you wake up during the night. When you cough, reach down and put pressure on your groin dressing. This may help prevent bleeding.

    • Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with small coughs. Put any spit you have coughed up into a tissue. Take 10 deep breaths in a row every hour.

    • You may be given an incentive spirometer. An incentive spirometer helps you take deeper breaths. Put the plastic piece in your mouth and take a very deep breath. Hold your breath as long as you can. Then let out your breath. Use your incentive spirometer 10 times in a row every hour.

  • Medicines: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

© 2014 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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