Abdominal aortic aneurysm repair - open
AAA - open; Repair - aortic aneurysm - openOpen abdominal aortic aneurysm (AAA) repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The aorta is the large artery that carries blood from your heart to your belly (abdomen), pelvis, and legs.
Aneurysm
An aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.
Read Article Now Book Mark ArticleAn aortic aneurysm is when part of this artery becomes too large or balloons outward.
Aortic aneurysm
An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. A thoracic aortic aneury...
Read Article Now Book Mark ArticleDescription
The surgery will take place in an operating room. You will be given general anesthesia (you will be asleep and pain-free).
General anesthesia
General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...
Read Article Now Book Mark ArticleYour surgeon opens up your belly and replaces the aortic aneurysm with a man-made, cloth-like material.
Here is how it can be done:
- In one approach, you will lie on your back. The surgeon will make a cut in the middle of your belly, from just below the breastbone to below the belly button. Rarely, the cut goes across the belly.
- In another approach, you will lie slightly tilted on your right side. The surgeon will make a 5- to 6-inch (13 to 15 centimeters) cut from the left side of your belly, ending a little below your belly button.
- Your surgeon will replace the aneurysm with a long tube made of man-made (synthetic) cloth. It is sewn in with stitches.
- In some cases, the ends of this tube (or graft) will be moved through blood vessels in each groin and attached to those in the leg.
- Once the surgery is done, your legs will be examined to make sure that there is a pulse. Most often a dye test using x-rays is done to confirm that there is good blood flow to the legs.
- The cut is closed with sutures or staples.
Surgery for aortic aneurysm replacement may take 2 to 4 hours. Most people recover in the intensive care unit (ICU) after the surgery.
Why the Procedure Is Performed
Open surgery to repair an AAA is sometimes done as an emergency procedure when there is bleeding inside your body from the aneurysm.
You may have an AAA that is not causing any symptoms or problems. Your health care provider may have found the problem after you had an ultrasound or CT scan done for another reason. There is a risk that this aneurysm may suddenly break open (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky, depending on your overall health.
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
Read Article Now Book Mark ArticleCT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
Read Article Now Book Mark ArticleYou and your provider must decide whether the risk of having this surgery is smaller than the risk for rupture. Surgery is more likely to be suggested if the aneurysm is:
- Larger (about 2 inches or 5 centimeters)
- Growing more quickly (a little less than 1/4 inch over the last 6 to 12 months)
Risks
The risks for this surgery are higher if you have:
- Heart disease
Heart disease
Coronary heart disease is a narrowing of the blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called co...
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Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
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- Past stroke
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
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Complications are also higher for older people.
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
- Breathing problems
Breathing problems
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Heart attack or stroke
Heart attack
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...
Read Article Now Book Mark ArticleStroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark Article - Infection, including in the lungs (pneumonia), urinary tract, and belly
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
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Risks for this surgery are:
- Bleeding before or after surgery
- Damage to a nerve, causing pain or numbness in the leg
- Damage to your intestines or other nearby organs
- Loss of blood supply to a portion of the large intestine causing delayed bleeding in the stool
- Infection of the graft
- Injury to the ureter, the tube that carries urine from your kidneys to your bladder
- Kidney failure that may be permanent
- Lower sex drive or inability to get an erection
Inability to get an erection
An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...
Read Article Now Book Mark Article - Poor blood supply to your legs, your kidneys, or other organs
- Spinal cord injury
Spinal cord injury
Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the nearby bones,...
Read Article Now Book Mark Article - Wound breaks open
- Wound infections
- Death
Before the Procedure
Your will have a physical exam and get tests before you have surgery.
Always tell your provider what medicines you are taking, even drugs, supplements, or herbs you bought without a prescription.
If you are a smoker, you should stop smoking at least 4 weeks before your surgery. Your provider can help.
During the 2 weeks before your surgery:
You will have visits with your provider to make sure medical problems such as diabetes, high blood pressure, and heart or lung problems are well treated.
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark ArticleHigh blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
Read Article Now Book Mark Article- You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naproxen (Aleve, Naprosyn), and other drugs like these.
- Ask which drugs you should still take on the day of your surgery.
- Always tell your provider if you have a cold, flu, fever, herpes breakout, or other illness before your surgery.
DO NOT drink anything after midnight the day before your surgery, including water.
On the day of your surgery:
- Take the drugs you were told to take with a small sip of water.
- You will be told when to arrive at the hospital.
After the Procedure
Most people stay in the hospital for 5 to 10 days. During a hospital stay, you will:
- Be in the intensive care unit (ICU), where you will be monitored very closely right after surgery. You may need a breathing machine during the first day.
- Have a urinary catheter.
Urinary catheter
A urinary catheter is a tube placed in the body to drain and collect urine from the bladder.
Read Article Now Book Mark Article - Have a tube that goes through your nose into your stomach to help drain fluids for 1 or 2 days. You will then slowly begin drinking, then eating.
- Receive medicine to keep your blood thin.
- Be encouraged to sit on the side of the bed and then walk.
- Wear special stockings to prevent blood clots in your legs.
- Be asked to use a breathing machine to help clear your lungs.
- Receive pain medicine into your veins or into the space that surrounds your spinal cord (epidural).
Outlook (Prognosis)
Full recovery for open surgery to repair an aortic aneurysm may take 2 or 3 months. Most people make a full recovery from this surgery.
Most people who have an aneurysm repaired before it breaks open (ruptures) have a good outlook.
References
Cameron J. Vascular surgery. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:993-1214.
Sharafuddin MJ. Abdominal aortic aneurysms: open surgical treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 73.
- Pneumonia - InDepth(In-Depth)
Review Date: 10/18/2022
Reviewed By: Deepak Sudheendra, MD, MHCI, RPVI, FSIR, Founder and CEO, 360 Vascular Institute, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Columbus, OH. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.