Open abdominal aortic aneurysm repair is surgery to fix a widened part (or aneurysm) in your aorta, the large artery that carries blood to your belly (abdomen), pelvis, and legs.
An aortic aneurysm is when part of this artery becomes too large or balloons outward.
Your surgeon opens up your belly and replaces the aortic aneurysm with a fabric material.
Alternative NamesAAA - open; Repair - aortic aneurysm - open
DescriptionThe surgery will take place in an operating room. You will be given general anesthesia (asleep and pain free).
See also: Aortic aneurysm repair - endovascular
Why the Procedure Is PerformedOpen surgery to repair an abdominal aortic aneurysm is sometimes done as an emergency when there is any bleeding inside your body from the aneurysm.
You may also have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from special tests called ultrasound or CT scan. There is a risk that this aneurysm may open up (rupture) if you do not have surgery to repair it. But surgery to repair the aneurysm may also be risky.
You and your doctor must decide whether the risk of having this surgery is smaller than the risk of bleeding if you do not have the surgery. The doctor is more likely to recommend surgery if the aneurysm is:
The risks for this surgery are higher if you have heart disease, lung disease, kidney failure, or other serious medical problems. Risks or problems or complications are also higher for older people.
Risks for any surgery are:
Risks for this surgery are:
Your doctor will do a thorough physical exam and tests before you have surgery.
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
If you are a smoker, you should stop. Your doctor or nurse can help.
During the 2 weeks before your surgery:
Do NOT drink anything after midnight, the day before your surgery, including water.
On the day of your surgery:
Most people stay in the hospital for 5 to 10 days. During a hospital stay, you will:
Full recovery for open surgery to repair an aortic aneurysm may take 2 or 3 months. Most people make a full recovery from this surgery.
ReferencesGloviczki P, Ricotta JJ II. Aneurysmal vascular disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 65.
Greenhalgh RM, Powell JT. Endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2008 Jan 31;358(5):494-501.
Lederle FA, Kane RL, MacDonald R, Wilt TJ. Systematic review: repair of unruptured abdominal aortic aneurysm. Ann Intern Med. 2007 May 15;146(10):735-41.
Open abdominal aortic aneurysm repair is surgery to fix a widened part (aneurysm) in your aorta, the large artery that carries blood to your belly (abdomen), pelvis, and legs.
An aortic aneurysm is when part of this artery becomes too large or balloons outward.
Your surgeon opens up your belly and replaces the aortic aneurysm with a man-made, cloth-like material.
Alternative NamesAAA - open; Repair - aortic aneurysm - open
DescriptionThe surgery will take place in an operating room. You will be given general anesthesia (you will be asleep and pain-free).
Surgery for aortic aneurysm replacement may take 2 to 4 hours. Most patients recover in the intensive care unit (ICU) after the surgery.
See also: Aortic aneurysm repair - endovascular
Why the Procedure Is PerformedOpen surgery to repair an abdominal aortic aneurysm is sometimes done as an emergency procedure when there is any bleeding inside your body from the aneurysm.
You may also have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from tests called ultrasound or CT scan. There is a risk that this aneurysm may suddenly break open (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky, depending on your overall health.
You and your doctor must decide whether the risk of having this surgery is smaller than the risk of rupture if you do not have the surgery. The doctor is more likely to recommend surgery if the aneurysm is:
The risks for this surgery are higher if you have:
Risks of problems or complications are also higher for older people.
Risks for any surgery are:
Risks for this surgery are:
Your doctor will do a thorough physical exam and tests before you have surgery.
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
If you are a smoker, you should stop smoking at least 4 weeks before your surgery. Your doctor or nurse can help.
During the 2 weeks before your surgery:
Do NOT drink anything after midnight the day before your surgery, including water.
On the day of your surgery:
Most people stay in the hospital for 5 to 10 days. During a hospital stay, you will:
Full recovery for open surgery to repair an aortic aneurysm may take 2 or 3 months. Most people make a full recovery from this surgery.
Most people who have an aneurysm repaired before it breaks open (ruptures) have a good outlook.
ReferencesGloviczki P, Ricotta JJ II. Aneurysmal vascular disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 65.
De Bruin JL, Baas AF, Buth J, Brinssen M, Verhoeven EL, Cuypers PW, et al: DREAM Study Group. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med; 2010:362:1881-1889.
United Kingdom EVAR Trial Investigators, Grenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med; 2010;362:1863-1871.
Reviewed ByReview Date: 11/18/2010
Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The infrarenal abdominal aortic aneurysm can be repaired through different types of surgery. The two main types of surgical repair include open repair and endovascular repair.
Open surgical repair or endovascular repair.
abdominal aortic aneurysm...... this is when the main artery from your heart that passes blood through your stomach is blocked. caused by clotting. an abdominal aorticaneurysm is a serious life threatening condition and should be treated immediately. if the aneurysm reaches to a point where it bursts the person may only have minutes even seconds left to live. the symptoms of an abdominal aortic aneurysm are.... pulsating of the stomach... abdominal cramps or stiff feeling pains in the lower back.. you may feel Daisy or light headed when exercising or lifting heavy objects. tiredness, decreased appetite, these are only a few of the symptoms, if you are curious and want more information the do not hesitate to contact your local GP after all that's what there their for. thanks Andy cardiovascular surgeon abdominal aortic aneurysm...... this is when the main artery from your heart that passes blood through your stomach is blocked. caused by clotting. an abdominal aorticaneurysm is a serious life threatening condition and should be treated immediately. if the aneurysm reaches to a point where it bursts the person may only have minutes even seconds left to live. the symptoms of an abdominal aortic aneurysm are.... pulsating of the stomach... abdominal cramps or stiff feeling pains in the lower back.. you may feel Daisy or light headed when exercising or lifting heavy objects. tiredness, decreased appetite, these are only a few of the symptoms, if you are curious and want more information the do not hesitate to contact your local GP after all that's what there their for. thanks Andy cardiovascular surgeon
DefinitionEndovascular abdominal aortic aneurysm repair is surgery to fix a widened part (or aneurysm) in your aorta, the large artery that carries blood to your belly, pelvis, and legs.An aortic aneurysm is when a part of this artery becomes too large, or balloons outward, due to weakness in the wall of the artery.Alternative NamesEVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascularDescriptionYou will lie down on a padded table in an operating room, in the radiology department of the hospital, or in a catheterization lab. You may receive general anesthesia (asleep and pain-free) or epidural or spinal anesthesia.Your doctor will make a small incision (cut) near the groin, to find the femoral artery. Then your doctor will insert a stent (a metal coil) and a manmade (synthetic) graft through the cut into the artery.The doctor uses x-rays to guide the stent graft up into your aorta, to where the aneurysm is located. The doctor will open the stent using a spring-like mechanism and attach it to the walls of the aorta. Your aneurysm will eventually shrink around it.The doctor will then use x-rays again to make sure the stent is in the right place and your aneurysm is not bleeding inside your body.Why the Procedure Is PerformedIf you have bleeding inside your body from an aortic aneurysm, you will have open abdominal aortic aneurysm repair. Endovascular repair is rarely done for a leaking or bleeding aneurysm.You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from special tests called an ultrasound or CT scan. There is a risk that this aneurysm may open up (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky.You and your doctor must decide whether the risk of having this surgery is smaller than the risk of bleeding if you do not have surgery to repair the problem. The doctor is more likely to recommend you have surgery if the aneurysm is:Larger (about 2 inches)Growing more quickly (a little less than 1/4 inch over the last 6 to 12 months)Endovascular repair has a lower risk of complications around the time of the surgery. Your doctor is more likely to suggest this surgery if you have other more serious medical problems or if you are elderly.RisksRisks for any surgery are:Reactions to medicinesBreathing problemsBlood clots in the legs that may travel to the lungsHeart attack or strokeInfection, including in the lungs, urinary tract, and bellyRisks for this surgery are:Bleeding before or after procedurePoor blood supply to your legs, your kidneys, or other organsDamage to a nerve, causing pain or numbness in the legBleeding around the graft requiring more surgeryBefore the ProcedureYour doctor will do a thorough physical exam and tests before you have surgery.Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.If you are a smoker, you should stop. Your doctor or nurse can help.During the 2 weeks before your surgery, you will visit your doctor to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems, are being treated well.You also may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), naprosyn (Aleve, Naproxen), and other drugs like these.Ask your doctor which drugs you should still take on the day of your surgery.Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.Do NOT drink anything after midnight, the day before your surgery, including water.On the day of your surgery:Take the drugs your doctor told you to take with a small sip of water.Your doctor or nurse will tell you when to arrive at the hospital.After the ProcedureMost people stay in the hospital for 3 to 5 days after this surgery, depending on the type of procedure you had. During a hospital stay, you may:Be in the intensive care unit (ICU), where you will be watched very closely at firstHave a urinary catheterBe given medicines to keep your blood thinBe encouraged to sit on the side of your bed and then walkWear special stockings to prevent blood clots in your legsReceive pain medicine into your veins or into the space that surrounds your spinal cord (epidural)Outlook (Prognosis)Recovery after endovascular repair is usually fairly quick. You will need to be watched carefully over time for signs or symptoms that your repaired aortic aneurysm is leaking blood.ReferencesGloviczki P, Ricotta JJ II. Aneurysmal vascular disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 65.Greenhalgh RM, Powell JT. Endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2008 Jan 31;358(5):494-501.Lederle FA, Kane RL, MacDonald R, Wilt TJ. Systematic review: repair of unruptured abdominal aortic aneurysm. Ann Intern Med. 2007 May 15;146(10):735-41.
Why would you want to do that. You would have to cut open the heart and watch the blood move from the pulmonary artery through the heart and into the right radial artery.
During systole, both atrioventricular valves (tricuspid and mitral) are closed. The aortic valve is open. During diastole, both atrioventricular valves are open, and the aortic valve is closed.
An Aneurysm is usually a blood vessel in the brain, that balloons, then breaks.
DefinitionA thoracic aortic aneurysm is a widening (bulging) of part of the wall of the aorta, the body's largest artery.Alternative NamesAortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aorticCauses, incidence, and risk factorsThoracic aneurysms most often occur in the descending thoracic aorta. Others may appear in the ascending aorta or the aortic arch.The most common cause of a thoracic aortic aneurysm is hardening of the arteries (atherosclerosis).Other risk factors include:Connective tissue disorders such as Marfan syndromeHaving high blood pressure for a long timePrevious dissection of the aortaSyphilisTrauma such as falls or motor vehicle accidentsSymptomsMost patients have no symptoms until the aneurysm begins to leak or expand. Chest or back pain may mean sudden widening or leakage of the aneurysm.Signs and testsThe physical examination is often normal. Most nonleaking thoracic aortic aneurysms are detected by tests -- usually a chest x-ray or a chest CT scan -- run for other reasons. A chest x-ray and chest CT scan show if the aorta is enlarged. A chest CT scan shows the size of the aorta and the exact location of the aneurysm.An aortogram (a special set of x-ray images made when dye is injected into the aorta) can identify the aneurysm and any branches of the aorta that may be involved.TreatmentThe treatment depends on the location of the aneurysm.For patients with aneurysms of the ascending aorta or aortic arch, surgery to replace the aorta is recommended if the aneurysm is larger than 5 - 6 centimeters. The aorta is replaced with a fabric substitute.This is major surgery that requires a heart-lung machine. If the aortic arch is involved, a specialized technique called "circulatory arrest" may be necessary. This involves a period without blood circulation while the patient is on life support.There are two options for patients with aneurysms of the descending thoracic aorta. If the aneurysm is larger than 6 centimeters, major surgery is done to replace the aorta with a fabric substitute.Endovascular stenting is a less invasive option. A stent is a tiny metal or plastic tube that is used to hold an artery open. Stents can be placed into the body without cutting the chest.Instead, tiny, hollow tubes called catheters are inserted into the groin area. The stent is passed through the catheter and into the area of the aneurysm. Not all patients with descending thoracic aneurysms are candidates for stenting, however.Expectations (prognosis)The long-term prognosis for patients with thoracic aortic aneurysm is determined by other medical problems such as heart disease and diabetes, which may have caused or contributed to the condition.ComplicationsSerious complications after aortic surgery can include:BleedingGraft infectionHeart attackIrregular heartbeatKidney damageParalysisStrokeDeath soon after the operation occurs in 5 - 10% of patients.Complications after aneurysm stenting include damage to the leg, which may require another operation.Calling your health care providerTell your doctor if you have:A family history of connective tissue disordersChest or back discomfortPreventionTo prevent atherosclerosis:Control your blood pressure and blood lipid levels.Do not smoke.Exercise regularly.ReferencesSafi HJ, Estrera AL, Miller CC 3rd, Azizzadeh A, Porat EE. Thoracic vasculature with emphasis on the thoracic aorta. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 63.
A swollen blood vessel is called an aneurysm. If a brain aneurysm ruptures, it can hemorrhage into the brain. Bleeding from a ruptured aneurysm is one form of stroke, or cerebrovascular accident (CVA).
open and unobstructed
DefinitionAn aneurysm is a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out. It can leak blood and cause a stroke or bleeding along the surface of the brain (also called a subarachnoid hemorrhage).See also: Aneurysm in the brainAlternative NamesAneurysm repair - cerebral; Cerebral aneurysm repair; Coiling; Saccular aneurysm repair; Berry aneurysm repair; Fusiform aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brainDescriptionYour doctor will decide the best way to perform surgery on your aneurysm. Endovascular repair, most often using a "coil" or coiling, is a less invasive way to treat some aneurysms.During endovascular repair of an aneurysm, your surgeon blocks off the aneurysm before it can break open (ruptures).It is usually done in the radiology section of the hospital. You will have general anesthesia and a breathing tube.A catheter is guided through a small cut in your groin to an artery and then to the small blood vessels in your brain where the aneurysm is. Thin metal wires are put into the aneurysm. They then coil up into a mesh ball. Blood clots that form around this coil prevent the aneurysm from breaking open and bleeding.During and right after this procedure, you may be given a blood thinner called heparin.Why the Procedure Is PerformedIf an aneurysm in the brain ruptures, it is an emergency and needs medical treatment, and often surgery. Endovascular repair is more often used when this happens.A person may have an aneurysm but not any symptoms. This kind of aneurysm may have been noticed when an MRI of your brain was done for another reason.Your doctor will help you decide whether it is safer to have surgery on the aneurysm or not.Clipping is the more common way to repair an aneurysm. This is done during an open craniotomy. See also: Brain surgery(craniotomy)RisksRisks for any anesthesia are:Reactions to medicationsBreathing problemsPossible risks of brain surgery are:Surgery on any one area may cause problems with speech, memory, muscle weakness, balance, vision, coordination, and other functions. These problems may be mild or severe, and they may last a short while or they may not go away.Blood clot or bleeding in the brainSeizuresStrokeInfection in the brainBrain swellingSigns of neurological problems include:Vision problems(from blindness to peripheral vision problems)Speech problemsConfusionProblems noticing things around youBehavior changesLoss of balanceor coordinationBefore the ProcedureThis procedure is often performed on an emergency basis. If it is not an emergency:Tell your doctor or nurse what drugs or herbs you are taking and if you have been drinking a lot of alcohol.Ask your doctor which drugs you should still take on the day of the surgery.Always try to stop smoking.You will usually be asked not to eat or drink anything for 8 hours before the surgery.Take the drugs your doctor told you to take with a small sip of water.Your doctor or nurse will tell you when to arrive.After the ProcedureA hospital stay for endovascular repair of an aneurysm may be as short as 1 to 2 days if there was no bleeding beforehand.The hospital stay after craniotomy and aneurysm clipping is usually around 4 to 6 days. When bleeding or other complications occur before or during surgery, the hospital stay can be 1 to 2 weeks, or more.You will probably have an x-ray test of the blood vessels in the brain (angiogram) before you are sent home.Outlook (Prognosis)After successful surgical treatment for an aneurysm, it is uncommon for it to bleed again. Growth of the aneurysm may be less likely after craniotomy and clipping when compared to intravascular repair, and both are more likely to prevent enlargement and bursting when compared to doing nothing.The outlook also depends on any brain damage that occurred from bleeding before, during, or after the surgery.ReferencesBashir Q, Badruddin A, Aletich V. Endovascular techniques for stroke prevention. Neurol Clinic. 2008 Nov;26(4): 1099-127.Patterson JT, Hanbali F, Franklin RL, Nauta HJW. Neurosurgey. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 72.
The Aortic valve opens to let oxygenated blood into the Aorta.