Have you or someone dear to you just found out that you have
an aneurysm of the abdominal aorta that perhaps needs repair?
It must have come as a big shock, especially if you just found out unexpectedly after a routine screening.
The good news is that with adequate planning, most aneurysms can be operated upon and repaired successful. There is a very significant reduction of risk of complications and death when surgery is planned.
An undiagnosed ruptured aneurysm without the advantage of careful planning of surgery carries a greater than 90% risk of death. Compare that to a risk of less than 17%, if a planned minimal invasive surgery is undertaken.
Most cases of abdominal aortic aneurysm are accidental finds, as they often go on without any symptoms. Large aneurysms more than 5cm in diameter (two inches) could cause upper or central abdominal pain that spreads to the back or to the groin.
The decision to operate on an aneurysm is usually taken if:
The single most important factor in deciding whether to undertake an abdominal aortic aneurysm repair or not is the size of the localized abnormal widening or ballooning.
If your aneurysm is more than 2 inches (5cm) in diameter, there is an increased risk of this rupturing causing sudden and profound internal bleeding and death. The best treatment option at this point is to operate.
Even with the presence of a large aneurysm, you can decide not to have an operation. Some people with a ruptured aneurysm are often deemed not suitable for surgery too. The decision not to operate might be appropriate if:
At the moment, there are only two options by way of choice of surgery to repair an abdominal aortic aneurysm, whether ruptured or not. They are:
An open abdominal aortic aneurysm repair involves the following:
The surgery takes about 40 minutes or less in the hands of some very fast vascular surgeons - from the first cut to the last stitch.
After the open abdominal aortic aneurysm repair surgery, you will be taken out of theater into the recovery room, gently allowed to wake up. You will find drips attached to you. There would be a heavy dressing or plaster over your abdomen. As you continue to wake up fully, you may start feeling some pain around the operation site. This is usually mild to moderate in intensity. Your attending anesthetist or nurse can get you some additional pain killers if you want. Do not hesitate to ask for.
You will need to stay in hospital for about 7 to 10 days after an abdominal aortic aneurysm repair.
You will need at least 6 weeks off work after discharge from hospital following an open repair of an abdominal aortic aneurysm. Some people recover quicker and would be fine even before this 6 weeks time frame, while some may need up to 10 weeks.
You can see complications of aortic aneurysm repairs here.
This is also referred to as EVAR for short. It is a minimally invasive surgery for the repair of AAA. This means that the repair does not involve a big operation or opening up of the abdomen. Endovascular abdominal aortic aneurysm repair surgery is increasingly used as the treatment of choice for:
This procedure has a huge advantage over open repair because it helps reduce the risk of death significantly. Up to 5 out of every 100 persons discharged after a successful repair of their aneurysm dies within the first 30 days with an open repair.
This number drops to about 1 in a 100, with EVAR or endovascular repair.
So too is the risk of death during an operation reduced significantly if this minimally invasive technique is used.
Endovascular abdominal aortic aneurysm repair involve the use of a small device to pass a graft into the ballooned part of the aorta through a small cut about the size of a pin head in the groin. The graft is passed through one of the arteries in the upper thigh or groin and allowed to open up and strengthen the weak wall of the ballooned aorta segment.
Have you or your loved one had an abdominal aortic aneurysm repaired? Or is one being planned and you have some queries? Whatever brought you here, we would love to hear from you. Tell us your story. Share your thoughts or questions here!
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