Operation / Prosthetic aortic aneurysm – Aneurysmectomy

Description treat aortic aneurysms

The aorta is the largest artery in the body. It begins in the heart and runs through the chest and abdomen. Sometimes the walls of the aorta weaken and bulge appears to them. Surgery to treat aortic aneurysms is performed, to reinforce the weakened area.

The reasons for the treatment of aortic aneurysms

• To prevent aneurysm rupture, which causes severe, life-threatening bleeding;
• Remove ruptured aneurysm and repair the damaged aorta.

Possible complications of the treatment of aortic aneurysms

If you plan to have surgery, you need to know about possible complications, which may include:

• Problems with general anesthesia (eg, dizziness, lowering blood pressure, breathlessness);
• Infection;
• Bleeding;
• The formation of a blood clot;
• Damage to the organs or tissues;
• Death.

Factors, that may increase the risk of complications include:

• Smoking;
• Emergency surgery due to rupture of the aneurysm;
• Heart disease;
• Previous episodes of transient ischemic attack or stroke;
• Lung disease;
• Depletion due to cancer;
• Diabetes;
• Obesity.

How is aneurysmectomy?

Preparation for the procedure

Before the surgery, the following tests must be pryti:

• Physical examination;
• A blood test;
• Roentgen – take a picture of internal structures;
• US – analysis, which uses ultrasound, to find the aneurysm;
• CT scan – type of X-ray, which uses computer, to make pictures of internal organs;
• MRT – analysis, which uses magnetic waves, to make pictures of structures of the body;
• Heart catheterization – tubular insertion instrument into a vein or artery (usually in the arm or leg), to detect problems with the heart and its blood supply;
• Electrocardiogram – analysis, which records the activity of the heart, measuring the electrical signals through the heart muscle.

It may be necessary to stop taking certain medicines a week before surgery:

• Anti-inflammatory drugs (eg, aspirin);
• Blood thinners, such as clopidogrel (Plaviks) or warfarin.

Before the surgery, you need to do the following:

• Do not eat or drink for 8-12 hours before surgery;
• Take laxatives and / or an enema, to cleanse the bowel;
• In the morning before the operation can take a shower with antibacterial soap;
• To prepare the conditions for a return home after surgery.

Anesthesia

When the operation uses general anesthesia. The patient is asleep during surgery.

Procedure aneurysmectomy

Depending on the location of the aneurysm bloodstream, perhaps, It should be transferred to the heart-lung machine. He will temporarily perform the work of the heart and lungs.

In the area of ​​the aneurysm will make the cut. It may be in the abdomen or chest. The aorta is clamped above and below the aneurysm. The doctor will open the aneurysm and clean it from the inside. The graft is sewn in place inside the section of the aorta. The fabric is wrapped around the graft aneurysm.

When the graft is installed in place of, clamps removed. This will allow blood flow through the aorta to go again. The incision is closed, using staples or stitches. Field operations closed sterile dressing.

Some aneurysms can be operated without laparotomy (opening the abdomen). Instead, the surgery is performed through a puncture, made in the groin arteries. But this type of procedure is not suitable for all patients. Best Mode operation should be discussed with a doctor.

After the procedure

After surgery, the patient is sent to the recovery room, for monitoring vital parameters and the condition after anesthesia. When the condition is stabilized, the patient is transferred to the general hospital ward.

Duration of operation

The operation can take anywhere from one to several hours.

Will it hurt?

Anesthesia will prevent pain during surgery. The incision site pain may persist for some time. For pain relief after surgery appoint appropriate painkillers.

The time spent in hospital

Usually ranges 4-7 days. Depending from complications during hospitalization may be increased.

Postoperative care

In the hospital

• It should remain in the ICU for the first day or more after surgery. Then the patient is transferred to the ward.
• In the first day or two, the patient will be connected to monitors, to monitor heart rate, breath, blood pressure, and blood oxygen levels. The doctor may also prescribe blood tests, chest X-rays, ECG and ultrasound operated area of ​​the aorta;
• Maybe, You will need to use catheters:
  • Urinary catheter – to drain urine;
  • The arterial catheter for blood pressure measurement;
  • Central venous catheter – To monitor the pressure in the heart;
  • The epidural catheter provides an introduction to painkillers;
• Levin tube – inserted through the nose into the stomach to remove secretions and provide nutrition to the body to restore normal bowel function;
• You may need to use a spirometer, Deep breathing and frequent coughing. This will help improve lung function after general anesthesia;
• It is recommended to wear special compression stockings after surgery. They can help reduce the likelihood of blood clots in the legs.

Home Care

Houses need to do the following, to ensure the normal postoperative recovery:

• Consult with your doctor about, what medicines to take home;
• You must check with your doctor, when it is safe to shower, bath, or to expose the surgical site to water;
• Gradually return to your normal activities;
• You must quit smoking;
• Avoid elevated blood pressure.

Recovery takes about six weeks. During this time the symptoms are, which were before surgery aneurysm, and the patient's condition seriously improved.

After surgery, you need to go to the hospital in the following cases

• The appearance of signs of infection, including fever and chills;
• Redness, edema, increased pain, bleeding, or any discharge from the incision;
• Pain or swelling in the abdomen;
• Nausea and / or vomiting, that persist for more than two days after discharge from the hospital, and tested after receiving appropriate medication;
• Strong pain, does not pass, even after use of painkillers;
• Pain, burning, Frequent urination, or blood in the urine;
• Cough, shortness of breath or chest pain;
• Pain or swelling in the legs, calves and feet.