Aneurysm Repair

Who needs an aneurysm surgery?

Aneurysm surgery is an emergency procedure that is advised for an individual who has aortic aneurysm. Some people require this procedure if they are at risk of aneurysm rupture. It typically happens when the patient's aneurysm is expanding or is causing troublesome symptoms.

Individuals who already have dissected or ruptured aortic aneurysms should consult their healthcare providers if they are experiencing symptoms like dizziness, vomiting, extreme pain in the chest area, fast heartbeat, etc.

Individuals with unruptured aneurysms also require surgery as it can still prove to be life-threatening. In this case, surgery is needed when the patient is experiencing pain in the groin, back, and belly, has a huge aneurysm that is 5 to 6 centimeters in diameter, and is facing an abnormal sensation in the belly region.

What are the types of surgery for aortic aneurysms?

There are mainly two main types of surgery conducted for aortic aneurysms:

• Open abdominal or open chest repair: This is an invasive procedure to treat an aortic aneurysm. In this procedure, the surgeon opens up the body to replace the damaged and weakened parts of the aorta with a tube that is created using a unique fabric. Open abdominal or open chest repair is a common and preferred option over endovascular repair.
• Endovascular Repair: Endovascular surgery for aortic aneurysms is a less invasive option in comparison to open chest repair. In this procedure, a graft is placed using a catheter, which is presented in the body through a tiny incision made in the groin region. The graft is then placed in the aneurysm site to sustain the weakened artery wall.

What tests or diagnostic procedures are conducted before the aneurysm surgery?

Some of the tests conducted before the aneurysm surgery include:

• Physical examination: To diagnose whether the patient has an aortic aneurysm, the surgeon will conduct a physical examination to examine the heart to check for any issues related to the blood flow. As a part of the exam, the doctor may also inspect the legs and feet of the patient.
• Abdominal ultrasound: The doctor can also conduct an abdominal ultrasound to check the size of the aneurysm. It helps in knowing how fast the aneurysm is expanding.
• Computed Tomography (CT) Scan: This imaging test helps in providing images of the aorta and in determining the size of the aneurysm. This scan helps evaluate the aorta in a detailed manner. It also helps the healthcare provider in gathering more information about the blood vessels of the kidney or its relation with an aneurysm.
• Angiogram: This test is also conducted to diagnose aortic aneurysm. It helps to know how much enlargement is present in the aorta and if other blood vessels are also involved.
• Complete Blood Count (CBC): Other than imaging tests, the doctor can also conduct certain blood tests like CBC to diagnose conditions like anemia or infection. A CBC blood test checks the overall health of the patient and measures the amount of RBCs, WBCs, and platelets.

What happens during an aneurysm surgery?

Before the procedure begins, your surgeon will give you general anesthesia so that you are not awake during the procedure. The surgeon will then make an incision depending on the procedure being performed. There are two kinds of aneurysm surgeries that are performed: open chest repair and endovascular aneurysm repair (EVAR).

In open chest surgery, the cut is made in the chest or abdomen. Whereas, in the EVAR the cut is made in the groin region.

Once the incision is made in open chest repair, the surgeon will use a clamp to close (seal) the blood flow from the parts of the aorta that lie above and below the aneurysm. The surgeon will then use a graft ( a tube) to replace it with damaged or weakened parts of the aorta. The graft which now acts as a new lining for the artery, is made using polyester. The graft is positioned using staples or stitches.

In endovascular aneurysm repair, a catheter is utilized to treat the aneurysm. The catheter is inserted through a small incision made in the groin region. The surgeon then inserts the graft using the catheter and places it inside the aneurysm. The graft helps in flowing the blood throughout the body bypassing the damaged parts of the aorta. The surgeon then staples or stitches the graft and removes the catheter.

When the procedure is completed, the healthcare team will close the incision made in the chest or belly using stitches or staples. Aneurysm operation usually takes around 4 to 5 hours, depending on the procedure that is performed.

How to prepare for aneurysm surgery?

Some of the steps that'll help a patient prepare for aneurysm surgery include:

• Before surgery make sure you convey to your healthcare provider about the medications and supplements you are consuming. It is essential because the doctor may stop the consumption of some medications before surgery.
• If you are suffering from high blood pressure, consult your doctor on how to manage this condition. Also, contact your doctor about any other issue you may be facing such as flu, or cold. These conditions can impact your surgical process.
• Abstain from smoking for at least 3 to 4 weeks before surgery. You can consult your healthcare provider on the ways to quit smoking.
• Do not consume anything, including water the night before the surgery, if advised by the doctor.
• Avoid alcohol consumption in the weeks leading up to surgery.
• Before surgery, ensure you have the required knowledge about the procedure. Educate yourself about the risks, advantages, and recovery period of the procedure.
• Whenever possible, practice relaxing and stress management techniques before surgery to handle stress and anxiety.

What are the recovery tips to follow after aneurysm surgery?

Here are some important recovery tips to follow after aneurysm operation :

• Post-surgery you can start with light daily activities such as walking. Slowly you can increase the level of activity when you feel comfortable.
• However, avoid heavy lifting and strenuous activities that might apply strain on the incision site.
• Avoid foods that have high sugar and fat quantity. Rather, switch to food items that have sufficient fiber and protein such as black beans, berries, eggs with vegetables, etc.
• After aneurysm surgery, you may see restricted movement of your shoulders and arms because of the incisions. Therefore, avoid driving for at least a month after surgery.
• Do not drink or smoke after your surgery as it can have a negative impact on your recovery period.
• If you experience pain and discomfort during your recovery phase, use pain medicines as prescribed by your healthcare team. However, don't exceed the dose without taking advice from your doctor. Use other pain relieving methods like gentle body movements, ice packs, etc to alleviate pain.