The aorta is the largest artery in the body. The abdominal portion of the aorta carries blood to the abdomen, pelvis, and legs. Sometimes the walls of the aorta weaken and bulge in one area. This is called an abdominal aortic aneurysm (AAA). AAAs are most often caused by
, also known as hardening of arteries, and
high blood pressure
Abdominal Aortic Aneurysm
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Surgery to repair an AAA is often done when the aneurysm: Causes physical symptoms such as abdominal painReaches a size of 2 inches (5 centimeters) across or has been growing rapidly. Smaller aneurysms are watched closely. They are rarely repaired with surgery.Has burst—Surgery must be done right away.
Preventive AAA surgery generally has a good outcome for people who are relatively healthy. Emergency surgery to fix an AAA rupture has a much lower survival rate, due to the rapid loss of blood.
Your doctor will review a list of possible complications, which may include: Problems from
general anesthesia, including lightheadedness, low blood pressure, and wheezingInfectionBleedingDamage to organsDeath
Some factors that may increase the risk of complications include: SmokingHeart disease
Previous episodes of
transient ischemic attack (TIA)
Lung diseaseWeakness due to cancerDiabetesObesity
The procedure varies. It can be done before a rupture as a preventive measure or after a rupture on an emergency basis. The preventive procedure is outlined here.
Your doctor may need detailed pictures of your abdomen, heart, and lungs. These can be made with: CT scanMRI scanChest x-rayAbdominal ultrasound
Your doctor may also need a record of your heart activity. This can be made with an
Your doctor may ask you to see a cardiologist—a doctor who specializes in heart conditions. The cardiologist will check your heart before surgery.
You may need to stop taking certain medications 1 week before surgery. Talk to your doctor about your regular medications.
On the day of the procedure, you will be given an antibiotic by IV. You may also be given a laxative or enema to clear out your bowels.
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.
This may be done as an open surgery or using an endovascular approach.
In an open surgery, an incision is made from the breastbone to below the belly button. The aorta is clamped slightly above and below the aneurysm. Any blood clot on the inside of the aorta is removed. An artificial wall is used to strengthen the area. This is called a graft. The graft will be stitched to the normal aorta on either side. Then, the clamps are removed. The wound is closed with stitches.
For the endovascular repair, a small incision will be made in your leg. A sleeve will be inserted in this incision and into the aorta. It will be advanced to the aneurysm. The sleeve will take pressure off the wall and prevent it from expanding or leaking. The incision will then be closed.
Abdominal Aortic Aneurysm Surgery
An artificial graft is stitched to the aorta.
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Anesthesia prevents pain during the procedure. Most people will be sore after the procedure and will be given pain medications.
The length of your hospital stay depends on your overall condition. Ask your doctor how long you should plan to stay.
While you are recovering at the hospital, you may receive the following care: You will be sent to the intensive care unit for monitoring.
You will have tubes in place, which may include the following:
IV—provides medications and fluidsUrinary catheter—monitors urine outputArterial catheter—monitors blood pressureCentral venous catheter—monitors pressure in the heartEpidural catheter—provides pain medicationNasogastric tube—inserted through the nose and into the stomach to remove secretions and provide nutrition until your intestines regain normal function
When you return home, do the following to help ensure a smooth recovery: To help prevent further problems, you and your doctor will need to work to increase your overall health. This can be done with medications and a healthy lifestyle. If you are a smoker, you should talk to your doctor about quitting.
Follow your doctor's instructions.
Contact your doctor if your recovery is not progressing as expected or you develop complications such as: Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision siteSigns of infection, including fever and chillsNew abdominal painBack painAny change of color or sensation in your legs or feetBurning, pain, or problems when urinatingNausea or vomiting
Abdominal cramps or
Unusual fatigue or
depressionDisorientation or confusionNumbness or tingling in the legsNew, unexplained symptomsCough, shortness of breath, or chest pain
In case of an emergency, call for emergency medical services right away.
Hall SW. Endovascular repair of abdominal aortic aneurysms (Home Study Program).
AORN Journal. 2003;77(3):630-642.
Last reviewed March 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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