by Scholten A
(Aneurysmectomy)

Definition

Aortic aneurysm repair is surgery to fix a bulge in the aorta. The bulge is called an aneurysm. The aorta is the largest artery in the body. It begins at the heart and runs through the chest and abdomen.

Reasons for Procedure

The procedure is often done when the aneurysm:

  • Causes symptoms
  • Gets too big
  • Has burst—which causes life-threatening bleeding

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia
  • Infection
  • Blood clots
  • Injury to nearby structures or organs

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor will give you general anesthesia. You will be asleep.

Description of Procedure

The surgery may be done one of two ways:

Open Surgery

An incision is made over the area of the aneurysm. This may be the abdomen or chest. The aorta is clamped slightly above and below the aneurysm. Any blood clot inside the aorta is removed. An artificial wall (graft) is used to strengthen the area. The graft will be stitched to the normal aorta on either side. Then, the clamps are removed. The wound is closed with stitches. A bandage will be placed over the site.

Endovascular Repair

A small incision is made in the leg. A stent will be inserted in this incision and into the aorta. It will be moved to the aneurysm. The stent will take pressure off the aorta wall. This will prevent it from bulging or leaking. The incision will then be closed. A bandage will be placed over the site.

Repair of Abdominal Aortic Aneurysm
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How Long Will It Take?

One to a few hours

Will It Hurt?

Soreness is common after the procedure. Medicine and home care help.

Average Hospital Stay

The usual length of stay is 4 to 7 days. It may be longer if there are problems.

Postoperative Care

At the Hospital

After the procedure, the staff may:

  • Give medicines to control pain or nausea
  • Give IV fluids and medicine
  • Place a tube through the nose and into the stomach—to remove secretions and provide nutrition

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incision covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home

Recovery takes about 6 weeks. Physical activity will be limited during this time.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excess bleeding, or discharge at the incision
  • Pain you cannot control with the medicine
  • Any change of color or feeling in your legs or feet
  • Belly cramps, loose stools (poop), or problems passing urine
  • Lasting nausea or vomiting
  • Cough, problems breathing, or chest pain
  • Unusual tiredness, low mood, or confusion

If you think you have an emergency, call for medical help right away.

RESOURCES

American Heart Association  http://www.heart.org 

The Society of Thoracic Surgeons  https://www.sts.org 

CANADIAN RESOURCES

Heart and Stroke Foundation of Canada  http://www.heartandstroke.ca 

University of Ottawa Heart Institute  https://www.ottawaheart.ca 

References

Abdominal aortic aneurysm repair. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/abdominal-aortic-aneurysm/abdominal-aortic-aneurysm-repair. Accessed August 26, 2021.

Aneurysm repair. The Texas Heart Institute website. Available at: https://www.texasheart.org/heart-health/heart-information-center/topics/aneurysm-repair/. Accessed August 26, 2021.

Endovascular aneurysm repair. Department of Surgery—University of California San Francisco website. Available at: https://surgery.ucsf.edu/conditions--procedures/endovascular-aneurysm-repair.aspx. Accessed August 26, 2021.

Hongku K, Dias NV, et al. Total aortic endovascular repair. J Cardiovasc Surg (Torino). 2016;57(6):784-805.

Thoracic aortic aneurysm. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/thoracic-aortic-aneurysm . Accessed August 26, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 08/26/2021