Aortic Aneurysm Repair

An aortic aneurysm repair surgery may be required if the aortic aneurysm causes the following symptoms:

• Abdominal pain
• Feeling of heartbeat in the abdomen
• Lower back pain
• Chest pain
• Back pain
• Jaw pain
• Neck pain
• Coughing
• Hoarseness
• Difficulty in breathing
• Rapidly growing aortic aneurysm (approximately ¼ inch over the last 6 to 12 months)
• Interference of blood flow to the other parts of the body, like the legs

If the aneurysm is larger than two inches : Aortic dissection (leaking of blood into the layers of the walls of the aorta) Rupture of aortic aneurysm, the symptoms of which are:

1. Anxiety
2. Pale and clammy skin
3. Nausea
4. Vomiting
5. Dry mouth
6. Excessive thirst
7. Weakness
8. Fainting
9. Dizziness
10. Sweating
11. Rapid heartbeat

1. Physical examination: The doctor will check you physically. Your medical history and family history are also noted.

2. Chest x-ray: It is a medical test done to visualize the organs, bones, and other structures inside the chest.

3. Blood tests: These tests help in evaluating the vital parameters of blood, and checking for any underlying medical conditions.

4. Electrocardiogram (EKG): It is a painless test done to record the electrical activity of the heart, and diagnose any heart problems.

The procedure may be performed under general anesthesia (the patient is put to sleep during the procedure) or regional anesthesia (a nerve block that is given to numb a large area of the body) with sedation (to keep you comfortable and relaxed).
One of the following approaches can be used for an aortic aneurysm repair surgery:

1. Endovascular aortic aneurysm repair:

• This procedure involves the insertion of a catheter and guide wire through an artery in the leg or groin region.
• The tip of the catheter has a deflated synthetic graft.
• This graft tends to expand like spring after the catheter is in place.
• The walls of the aorta are reinforced by the synthetic graft.
• The blood can now flow through the graft.
• This surgery is less painful, has fewer complications, and has less recovery time than open surgery, due to less trauma to the organs and tissues.
• If you are not a candidate for open surgery, this procedure may be performed. However, this procedure cannot repair all types of aneurysms.

2. Open surgery:

• This procedure involves making a large cut or incision in the abdomen or chest area, depending on where the aneurysm is present.
• The weakened part of the aorta is removed and replaced by a synthetic graft.
• The doctor may also choose to cut open the aneurysm and place the graft inside.
• This surgery allows the doctor to directly view and access the surgical area.
• This procedure usually requires a longer recovery, an increased risk of complications, and more pain than an endovascular surgery.
• An open surgery needs a larger incision and more cutting and displacement of the tissues, organs, and muscles than an endovascular surgery.
• Open surgery is still considered to be a more effective and safer method for some patients.

The following risks are involved with an aortic aneurysm repair surgery:

• Allergic reaction to anesthesia

• Bleeding

• Infection

• Blood clot formation

• Blockage of the graft

• Damage to the blood vessel

• Leaking of blood from the graft

• Nerve damage

• Bowel damage (if the procedure involves the abdomen)

• Spinal cord injury

• Sexual problems (in case of nerve injuries in the groin)

• Pain or bloating in the abdomen

• Breathing problems

• Dizziness

• Confusion

• Chest pain or pressure

• Coughing up green or yellow mucus

• Coughing up blood

• Fever

• Inability to urinate

• Inability to have a bowel movement

• Leg pain, swelling, or redness

• Pain that cannot be relieved using pain medications

• Drainage of pus, redness, or swelling on the incision site

1. The patient will be sent to the recovery room after the surgery and stay there till the vital signs are stable.

2. The patient is then moved to an intensive care unit (ICU), which provides 24-hour monitoring and care.

3. It may take a couple of hours for the anesthesia effect to wear off.

4. A breathing tube may be given in your mouth which will not allow you to talk, but it is normally removed in a few days.

5. It is normal to have a sore throat for a few days after the removal of the breathing tube.

6. You may be shifted to a normal room from the ICU once you start recovering.

7. You will be needed to stay in the hospital for two to five days after the endovascular procedure. 

8. After open surgery, you may be required to stay in the hospital for seven to ten days.

9. It is normal to have some pain and discomfort after the procedure.

10. The doctor may prescribe pain killers to ease the pain and discomfort.

11. The time of recovery depends on the type of procedure done, the age of the patient, the overall health status of the patient, and other factors.

12. The doctor may recommend an exercise rehabilitation program for a quicker recovery.

13. Follow all the diet, lifestyle, and activity restrictions that the doctor gives you.

14. Inform your doctor if you notice any unusual symptoms after the procedure.

15. Complete recovery may take two weeks to a couple of months.

16. Follow-up visits and imaging tests are done to check the graft periodically.

17. Additional procedures may be required in the future to maintain the graft.