An aortic aneurysm is a bulge in your aorta, the main blood vessel that carries blood from your heart to the rest of your body. Arteries usually have strong, thick walls. But sometimes, certain illnesses or problems with your genes make them weak. The force of your blood constantly pushing against those weakened walls can make them swell. The result is a balloon-like bulge, called an aneurysm. If it grows too large and bursts, it can become an emergency. So it needs treatment as soon as possible.
Doctors can usually treat small aneurysms with medication. But larger ones may need surgery.
There are two main types of surgery for aortic aneurysms:
- Open abdominal or open chest repair
- Endovascular repair
Open Abdominal or Open Chest Repair
This is the most common type of surgery to repair an aortic aneurysm, but it’s the most invasive, meaning that your doctor will go into your body to do it. Your surgeon replaces the weakened section of your aorta with a tube, or “graft,” made of a special fabric.
First, you’ll get general anesthesia. That means that you won’t be awake for the procedure.
Then your surgeon will make a cut either in your belly or chest, depending on where your aneurysm is located.
The surgeon will then remove the section of your aorta that is bulging and replace it with the fabric graft. The graft will allow blood to flow through the aorta without making it swell. Finally, she'll remove the clamps and allow the blood to start flowing again.
The entire procedure can take anywhere from 2 to 6 hours and you may have to stay in the hospital for up to a week to recover. You should be able to get back to your normal activities in about a month.
Life after open chest repair. You'll need to take aspirin for the first 6 weeks following surgery to prevent blood clots from forming. Your doctor will also likely put you on medicines called diuretics, or “water pills,” to prevent fluids from building up.
You can shower as soon as you get home. The first 2 weeks after surgery you may often feel tired. If so, take a nap. Your energy level will eventually improve.
Your chest may also feel sore and you may be given a breathing device to help you breathe more easily.
By week 3, you should be able to drive. You'll usually be back into your normal routine in 4 to 6 weeks. But it might take 2 to 3 months to feel completely recovered.
If you’re not able to get open chest or abdominal repair, your doctor may suggest endovascular repair. In this procedure, your surgeon inserts a flexible wire frame sewn onto a special fabric tube, called a stent graft, into your aorta, using a very thin tube, or catheter.
The stent graft helps support the weakened artery wall. You may or may not get general anesthesia for this procedure.
Afterward, you’ll stay in the hospital for 24 hours to 2 days. But not all aneurysms can be repaired with this method.
Life after endovascular repair. You may have less appetite and energy than usual for the first 2 weeks after surgery. But then they should return to normal.
You’ll need to avoid heavy lifting, of more than 10 pounds or so, until you are completely recovered, which usually takes about 4 to 6 weeks.
Regardless of the type of surgery you've had, you should join a cardiac rehabilitation program. There, you'll learn about how to change your diet, quit smoking, manage stress, and exercise to get your strength back. All of these will help keep your heart, and your aorta, strong and fit.
Your doctor should recommend a cardiac rehab program, and your insurance will likely cover it.