Aortic Aneurysm Surgery
An aortic aneurysm is a large abnormal bulge that can occur in the wall of major blood vessels (aorta) that carry blood from the heart to other parts of the body. These aneurysms can occur anywhere in the aorta. They are either tube-shaped (fusiform) or can be round-shaped (saccular). You will need an abdominal aortic aneurysm repair when the aneurysm is passing through your stomach. A thoracic aortic aneurysm repair is required when the aneurysm passes through the aorta in the chest cavity. In rare cases, individuals can have both, abdominal and thoracic aneurysms in their body. If the aneurysm ruptures, it can be life-threatening as the aorta is the main supplier of blood for the body. Based on the growth rate and size of the aortic aneurysm, your surgeon will devise a treatment plan, consisting of either watchful waiting or an emergency surgery.
Stomach aneurysms usually grow slowly, without any visible symptoms, making them quite tough to detect. In some cases, the aneurysm might never rupture. While some will always stay small, others might grow over time or some rare ones might expand quickly. It is difficult to predict the growth rate of the aneurysm and whether it will rupture in your body. If the abdominal aortic aneurysm is enlarging, you might notice the following symptoms: • A pulsating feeling near the navel area • Severe and constant pain in your stomach or on one side of your abdomen • Intense back pain If you have any of the above symptoms, it may be time to see a doctor at the earliest. Men and smokers have a higher risk of developing an abdominal aneurysm and therefore, they must opt for an ultrasound from time to time, especially those in the age of 65 to 75. If you have a family history of aneurysms, it also might be a good idea to get tested at regular intervals.
The doctor will conduct a thorough physical exam and prescribe various tests to determine your overall health condition. These will include chest X-rays to check for heart aneurysms, blood tests, ECG, abdominal ultrasound, CT scan or MRI, based on your individual conditions. If you are a smoker, you will have to stop smoking at least 4 weeks before your surgery. Also, make sure to tell your doctor all medications and non-prescription pills or supplements that you might be taking. Once your surgery is scheduled, the doctor will also prescribe a series of medications and precautions that must be strictly followed to ensure a safe surgery.
Your surgeon will normally recommend a surgery if the size of your aneurysm is around 1.9 to 2.2 inches or bigger. Surgery will also be recommended if the aneurysm is growing at an unexpectedly faster rate. There are two kinds of surgery options for aneurysm treatment including: Open Abdominal Surgery – This procedure involves removing the damaged part of the aorta and replacing it with a graft / synthetic tube that is sewn into its place. This surgery is done under general anaesthesia and requires an open stomach surgery. It usually takes patients more than a month to recover from this procedure. Endovascular Surgery – This is a more modern and innovative technique used to repair an aneurysm. It is also less invasive and promises better results. In this procedure, your surgeon will attach a synthetic graft to a thin tube (catheter) that is inserted into your artery through your legs. It is then threaded up to your aorta and the graft is placed at the aneurysm’s site and expanded. The graft has a metal mesh support with small hooks or pins that are used to fasten it in its place. This graft reinforces the weak part of the aorta and prevents rupturing. Recovery time is usually less in an endovascular procedure. However, 30% patients with an aortic aneurysm may not be able to opt for this method. Based on your condition and the location and size of your aneurysm, your surgeon will choose the best procedure.
You might have to stay in the hospital for 7-10 days for your aortic aneurysm treatment. You will be kept in an ICU for the first two days after the surgery and be closely monitored by doctors and nurses. You might also need a breathing machine and a urinary catheter during your hospital stay. The surgeon might also insert a tube from your nose into your stomach to enable fluid intake for the first 1-2 days. Later, you can start drinking and eating by yourself. You will be given a blood thinning medicine and asked to wear special stockings to prevent blood clots in your legs. Complete recovery will take about 2 to 3 months but you can be assured of a 100% recovery if you opted for a surgery before the aneurysm breaks open.
RISK AND COMPLICATIONS
Generally, the risks of aortic aneurysm surgery are higher for patients who might have the following ailments: • Previous stroke • Lung disease • Heart disease • Kidney failure • Or any other serious medical problem Also, the risks and complications of the surgery can be higher for senior citizens as their body might find it tougher to recover. The known risks after surgery for aortic aneurysm include: • Excessive bleeding before or after the surgery • Damage to the intestine or other nearby organs • Infection of the graft or wound infection • Reduced blood supply to your legs, kidney or other organs • A spinal cord injury • In rare cases, a heart attack or a stroke • Damage to a nerve that may cause numbness in the legs