Surgery for an abdominal aortic aneurysm

Traditional surgery to repair an abdominal aortic aneurysm involves making a large abdominal cut, temporarily redirecting blood flow around the aneurysm, removing the excess, stretched-out portion of the aorta-the aneurysm-and then inserting a man-made graft to replace the damaged section of the aorta.

Prior to the operation you will see an anesthesiologist and possibly a cardiologist, have standard blood tests and a chest X-ray taken. The night before the surgery you will be advised not to eat or drink after dinner. Many surgeons will prescribe an antibiotic the night before the operation, while others provide this at the time of surgery.

You may need an enema the night before surgery, or, in some cases, a more formal bowel preparation that may include antibiotics and substances to clean out the bowel. If you are admitted the night before surgery, an IV (intravenous line) will be placed and IV fluids provided overnight to keep you hydrated.

The morning of surgery a number of lines will be inserted into your body, including lines to monitor blood pressure and catheters to void urine. You will then receive anesthesia.

After the incision is made in the abdomen, an anticoagulant is administered to prevent blood clots. Affected arteries and blood vessels are clamped to prevent blood flow.

The aneurysm is then opened and cleaned. The surgeon inserts a graft to replace any portion of the aorta that has been removed. The graft is flushed to eliminate air and debris. The clamps are then removed to allow blood to flow again. This is done gradually to prevent fluctuations in blood pressure.

After the surgery, you are commonly placed in the intensive care unit for 24 to 48 hours. You are closely monitored for blood and fluid status, urine output and kidney function, bleeding, and respiratory status.

Surgery can sometimes be done by making an incision in the side instead of the abdomen.