Your surgeon will perform an abdominal aortic aneurysm repair to prevent the rupture of a bulging area of the aorta. Aorta is largest artery of the body. It is connected to heart and gets straight from left ventricle.
It is Formed of Four Parts:
- Ascending Aorta.
- Aortic Arch.
- Thoracic Aorta.
- Abdominal Aorta.
The Abdominal Aorta is largest part of aorta. Its function is to supply blood to lower portions of body inclusive of abdominal and pelvic organs. This ends around the level of navel where it gets separated into 2 iliac arteries which are responsible to transport blood to lower extremities.
The aorta has a thick wall so it can withstand the high pressure of blood being pumped from the heart. Over a period of time, the aortic walls become weak and slowly bulge outward in the form of balloon. When this condition occurs in abdominal region, it is called Abdominal Aortic Aneurysm.
Your surgeon will perform an open abdominal aortic aneurysm repair when the diameter of the aorta exceeds 2 inches or if you are having symptoms such as intense abdominal pain or an abnormally prominent abdominal pulsation.
Before the open procedure, an intravenous line (iv line) is placed to provide antibiotics, fluids, and anesthetic.
An open surgical repair is performed using general anesthesia, meaning the patient is sleeping during the entirety of procedure.
A breathing tube is inserted through mouth to promote breathing during procedure.
When you are asleep, a catheter is inserted into the bladder to drain urine and monitor kidney function.
The surgery is started by creating incision from breast bone to just below navel. The surgeon then locates the aneurysm and fastens aorta at its edges above as well as below. The surgeon then opens up aneurysm and sews artificial graft of the same shape and size as a normal aorta. The surgeon then closes the wall of aneurysm over this new graft. The graft will reinforce the walls of the aorta. The surgeon then closes the incision with stitches. The duration of procedure is generally 4-6 hours.
Your surgeon will perform endovascular aneurysm repair, a newer minimally invasive procedure, if you have severe heart disease or are at increased surgical risk due to age or other medical conditions.
Before the endovascular procedure, as with the open procedure, an intravenous line is placed to provide fluids and antibiotics.
You may receive general anesthesia or you may receive a sedative and an epidural or regional anesthesia to numb only the lower half of your body.
Your surgeon will begin by making a small incision in your groin over your femoral artery. Then he or she will insert a guidewire into the artery and gently push it up toward the site of your aneurysm.
A catheter or hollow tube will be passed over the guidewire and pushed toward the aneurysm. Using live x-ray pictures as a guide, the surgeon will pass an endovascular stent graft, a compressed fabric and metal tube, through the catheter to the aneurysm. Then, he or she will open the graft which will be held in place with metallic hooks and stents.
The surgeon may insert additional graft components to extend the graft into the blood vessels supplying your legs. Once the graft is in place, the blood will flow through it and not into the surrounding aneurysm sac which will remove the pressure from your aneurysm. Finally, your surgeon will remove the catheters and close the incisions in your groin. The procedure will generally take 2-3 hours.
Postprocedure, the breathing tube is removed and the patient is taken to ICU for recuperating. Fluids and nutrition are given intravenously. A tube may also be inserted through nose into the stomach in order to remove secretions till the time when the intestines start functioning again. The usual hospital stay for an open procedure is 5-10 days, while the stay for an endovascular procedure is usually shorter, at 2-3 days.