Abdominal aortic aneurysm repair - open - discharge
AAA - open - discharge; Repair - aortic aneurysm - open - discharge
Open abdominal aortic aneurysm (AAA) repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The aorta is the large artery that carries blood to your belly (abdomen), pelvis, and legs.
Your blood vessels are the transport system that carries blood to and from your heart, to the rest of your body. Usually, everything runs pretty smoothly with this system, but sometimes there can be a problem. For example, one of the large blood vessels that supplies blood to your abdomen and lower body can swell up or bulge. This bulge is called an abdominal aortic aneurysm, and it can be pretty serious if it breaks open, or ruptures. Let's talk about abdominal aortic aneurysm. This is the descending aorta, one of the large blood vessels that sends blood to your abdomen and legs. Over a period of many years, this blood vessel can start to bulge. Although doctors aren't sure exactly what causes an aneurysm, they do know that it's more common in males over 60 and people who are overweight, who smoke, or who have high blood pressure or cholesterol. Eventually, if not treated, the aneurysm can pop open or rupture, and spill blood into your abdominal cavity or into the wall of the artery. If an aneurysm ruptures, it is considered a true medical emergency. So, how do you find out if you have an aneurysm? You may not realize that you have one, because often aneurysms don't cause any symptoms until they rupture. An imaging test like a CT scan or ultrasound may help in finding a suspected aneurysm. If it does break open, you may feel severe pain in your stomach. That pain may spread to your groin, buttocks, or legs. You could also feel sick to your stomach, have clammy skin, and your heart may beat faster than normal. If you have any of these symptoms, see your doctor, who can examine you. Your doctor may also recommend an imaging test to see for sure if you have an aneurysm. Treatments for aneurysms vary depending on how severe the aneurysm is. If you're not having symptoms, and your aneurysm is small and hasn't broken open, your doctor may suggest just checking it every six months to make sure it doesn't get bigger. If it's bigger than 2 inches, you'll probably need to have surgery. The goal is to perform surgery before complications and symptoms develop. The surgeon will replace the damaged, bulging section of blood vessel with a section of man-made vessel, commonly called a graft. It's better to avoid getting an aneurysm than to have to treat it. Eat a healthy diet, watch your cholesterol and blood pressure levels, and quit smoking to help prevent an aneurysm from forming in the first place. Men who are over the age of 65 and have ever smoked or who have a close relative who's had an abdominal aortic aneurysm should have one screening ultrasound done to check for an abdominal aortic aneurysm. If you're having any symptoms of an abdominal aneurysm, like severe pain in your belly or back, it's very important that you get medical help right away. Go to the emergency room or call your health care provider for immediate help. Small aneurysms are easy to treat with surgery. But once they get larger and rupture, they can be life threatening.
When You're in the Hospital
You had open aortic aneurysm surgery to repair an aneurysm (a widened part) in your aorta, the large artery that carries blood to your belly (abdomen), pelvis, and legs.
You have a long incision (cut) either in the middle of your belly or on the left side of your belly. Your surgeon repaired your aorta through this incision. After spending 1 to 3 days in the intensive care unit (ICU), you spent more time recovering in a regular hospital room.
What to Expect at Home
Plan to have someone drive you home from the hospital. Do not drive yourself home.
You should be able to do most of your regular activities in 4 to 8 weeks. Before that:
- Do not lift anything heavier than 10 to 15 pounds (5 to 7 kg) until you see your health care provider.
- Avoid all strenuous activity, including heavy exercising, weightlifting, and other activities that make you breathe hard or strain.
- Short walks and using stairs are OK.
- Light housework is OK.
- Do not push yourself too hard.
- Increase how much you exercise slowly.
Managing pain
Your provider will prescribe pain medicines for you to use at home. If you are taking pain pills 3 or 4 times a day, try taking them at the same times each day for 3 to 4 days. They may be more effective this way.
Get up and move around if you are having some pain in your belly. This may ease your pain.
Press a pillow over your incision when you cough or sneeze to ease discomfort and protect your incision.
Make sure your home is safe as you are recovering.
Wound Care
Change the dressing over your surgical wound once a day, or sooner if it becomes soiled. Your provider will tell you when you do not need to keep your wound covered. Keep the wound area clean. You may wash it with mild soap and water if your provider says you can.
You may remove the wound dressings and take showers if sutures, staples, or glue were used to close your skin, or if your provider says you can.
If tape strips (Steri-strips) were used to close your incision, cover the incision with plastic wrap before showering for the first week. Do not try to wash off the Steri-strips or glue.
Do not soak in a bathtub or hot tub, or go swimming, until your doctor tells you it is OK.
Lifestyle Changes
Surgery does not cure the underlying problem with your blood vessels. Other blood vessels could be affected in the future, so lifestyle changes and medical management are important:
- Eat a heart-healthy diet.
- Get regular exercise.
- Stop smoking (if you smoke).
- Take the medicines your provider has prescribed as directed. These may include medicines to lower cholesterol, control blood pressure, and treat diabetes.
When to Call the Doctor
Call your provider if:
- You have pain in your belly or back that does not go away or is very bad.
- Your legs are swelling.
- You have chest pain or shortness of breath that does not go away with rest.
- You experience dizziness, fainting, or you are very tired.
- You are coughing up blood or yellow or green mucus.
- You have chills or a fever over 100.5°F (38°C).
- Your belly hurts or feels distended.
- You have blood in your stool or develop bloody diarrhea.
- You are not able to move your legs.
Also call your provider if there are changes in your surgical incision, such as:
- The edges are pulling apart.
- You have green or yellow drainage.
- You have more redness, pain, warmth, or swelling.
- Your bandage is soaked with blood or clear fluid.
References
DeAnda A, Worsham J, Mell M. The aorta. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 62.
Perler BA. Open repair of abdominal aortic aneurysms. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:901-905.
Version Info
Last reviewed on: 5/10/2022
Reviewed by: Deepak Sudheendra, MD, MHCI, RPVI, FSIR, Founder and CEO, 360 Vascular Institute, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Columbus, OH. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
