Definition

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 atherosclerosis, also known as hardening of arteries, and high blood pressure.

Abdominal Aortic Aneurysm Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

Surgery to repair an AAA is often done when the aneurysm:

• Causes physical symptoms such as abdominal pain
• Reaches 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—Requires emergency surgery.

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, because of rapid blood loss.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

• Problems from general anesthesia, including lightheadedness, low blood pressure, and wheezing
• Infection
• Bleeding
• Damage to organs
• Death

Some factors that may increase the risk of complications include:

• Smoking
• Heart disease
• Previous episodes of transient ischemic attack (TIA) or stroke
• Lung disease
• Weakness due to cancer
• Diabetes
• Obesity

What to Expect

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.

Description of Procedure

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. Copyright © Nucleus Medical Media, Inc.

Call Your Doctor

Call your doctor if any of the following occur:

• Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
• Signs of infection, including fever and chills
• New abdominal pain
• Back pain
• Any change of color or sensation in your legs or feet
• Burning, pain, or problems when urinating
• Persistent nausea or vomiting
• Abdominal cramps or diarrhea
• Unusual fatigue or depression
• Disorientation or confusion
• Numbness or tingling in the legs
• New or unexpected
• Cough, shortness of breath, or chest pain

If you think you are having an emergency, call for emergency medical services right away.