Open Aortic Aneurysm Repair

Your Care Explained > Tests and Procedures : Open Aortic Aneurysm Repair

You may not know of many other women who are undergoing this procedure. Because women generally don’t develop aortic aneurysms as early in life as men do, fewer undergo surgical repair. However, the procedure has been proven to be equally effective in men and women with comparable disease states.

This surgical procedure is used to reduce the risk of bleeding or rupture of an aortic aneurysm by replacing the region of the vessel containing the aneurysm with a synthetic graft.

Preparing for Surgery

What to Expect:

  • No food or drink the night before surgery.
  • No make-up, nail polish or jewelry in surgery.
  • You’ll sleep through the surgery.
  • You should be out of the ICU in 2 to 3 days.
  • You’ll leave the hospital about a week later.

In most cases, aortic aneurysm surgery is scheduled several weeks in advance, so you’ll have time to get ready. Because it helps to go into surgery in the best condition possible, you should try to follow a healthful diet, get adequate rest and, if you’re anxious about your upcoming surgery, practice techniques to reduce stress.

If you’re a smoker, this is a good time to stop, or at least cut down. If you drink alcohol daily, you might want to reduce your consumption to avoid the effects of alcohol withdrawal after surgery. You may have the opportunity to bank your blood, should you need a transfusion during the procedure.

A few days before surgery, you will meet with an anesthesiologist or nurse anesthetist, who will determine which type of anesthesia is best for you. You’ll answer questions on your health history and have a brief physical exam that may include ECG, blood work and urinalysis. You should bag all the medications—both prescription and over-the-counter—that you take regularly and bring the bag with you to the visit. The anesthesiologist or surgeon may want you to change the dose of, or even stop taking, some medications. The anesthesiologist will explain the type of anesthesia that you will receive, including the risks and benefits associated with it. You’ll read and sign a form consenting to the anesthesia to be used.

You will be asked not to eat or drink anything the night before surgery. You can take any drugs prescribed for surgery with a little water the morning of the procedure. You may be asked to wash your chest area with a special disinfecting soap.

You should arrive at the hospital without make-up, nail polish or jewelry, and dressed in clothing loose enough to fit over the surgical dressings you’ll be wearing when you go home. When you check in, you’ll be given an identification bracelet to wear during your stay. You’ll be given a hospital gown to wear and your clothes, handbag and other possessions will be tagged and taken to the room you will stay in after surgery.

A surgical attendant will explain what will happen during surgery as well as the risks involved. You’ll sign a second consent form, giving your permission to operate. Your anesthesiologist will greet you and might give you a sedative to relax you. A nurse will install an IV catheter in your arm or hand. You may be asked to remove any dental devices that can interfere with the tube that will be installed in your trachea to help you breathe during surgery. You will be transferred to a gurney and wheeled into the surgical suite.

The Operation

In the operating room, you’ll meet the leader of your surgical team, who will make you comfortable on the table. The anesthetist will place a clear mask over your nose and mouth and ask you to count backward from 10. You’re likely to be asleep before you finish counting.

Once you are unconscious, a tracheal tube will be inserted into your throat and connected to a ventilator to help you breathe. While you are unconscious, a nasogastric tube will be inserted into your nose and threaded down into your stomach. The second tube keeps the stomach empty during surgery. Your surgeons will make an incision in your chest or abdomen over the site of the aneurysm. Once your aorta is exposed, it is clamped above the aneurysm to prevent bleeding. The surgeon will remove the section of the aorta that contains the aneurysm and replace it with a synthetic graft, sewing the ends of the graft to the ends of the aorta. Once the graft has been completed, the clamp will be removed and blood flow restored.

After Surgery

After surgery, you may be taken to the recovery room or to the intensive care unit (ICU) to be closely monitored. You will be connected to monitors that will constantly display your electrocardiogram (ECG or EKG) tracing, blood pressure, other pressure readings, breathing rate and your oxygen level. You will have a tube in your throat that is connected to a ventilator until you are able to breathe on your own. As you awake from the anesthesia, the ventilator will be adjusted to allow you to take over more of the breathing. When you can breathe on your own and are able to cough, the breathing tube will be removed. The stomach tube will also be removed at this time.

Your nurse will have you cough and take deep breaths every two hours to keep mucus from collecting in your lungs and possibly causing pneumonia. Coughing will be uncomfortable because your chest will be sore, but your nurse will show you how to hug a pillow tightly against your chest while coughing to help ease the discomfort.

You may be on special IV drips to help your blood pressure and your heart, and to control any problems with bleeding. As your condition stabilizes, these drips will be gradually decreased and turned off.

The surgical incision may be tender or sore for several days after your graft procedure, so your doctor will prescribe a pain reliever for soreness. Be sure to take only recommended medications, because aspirin and other pain medications may increase the chance of bleeding.

When your physician determines that you are ready, you will be moved from the ICU to a post-surgical nursing unit. As you recover, you will be encouraged to get out of bed and walk around for longer periods of time. Your diet will be advanced to solid foods as you tolerate them.

When your doctor decides that you can go home, you’ll be given instructions for taking care of yourself. If you don’t have anyone to help you, you may be able to arrange for a nurse to visit.

Date Last Modified: January 21, 2011

Send Feedback To: BWH Women’s Health at bwhteleservices@partners.org

75 Francis Street, Boston, MA 02115 617.732.5500
harvard medical school partners healthcare © BWH 2011