The best method to repair an aneurysm depends upon several factors, including the location and shape of the aneurysm as well as the physical condition of the patient.
What is traditional open surgery for aneurysms?
Traditional open surgery as a treatment for abdominal aortic aneurysms and other types of aneurysm includes a long incision to gain access to and repair the aneurysm. Our physicians are recognized internationally for their extensive experience with surgical approaches for treating aneurysms.
Why is this procedure performed? Why do I need this procedure?
The goals of treatment are to reduce the risk of complications from aneurysms. The major risk for untreated aneurysms is rupture, and this threat increases with aneurysm size. The decision to treat an aneurysm with surgery is determined by many factors, including:
- The presence of symptoms, including abdominal or back pain, or pain in the groin or inner thigh
- The size of the aneurysm, specifically its diameter
- The occurrence of rapid aneurysm growth (if the diameter of aneurysm is growing more than 1 centimeter per year)
- The development of an aortic dissection, which can be heralded by sudden, severe sharp tearing pain in the chest or back
- The patient's overall medical condition
- The presence of a connective tissue disorder, such as Marfan Syndrome
Each patient is evaluated, and treatment will be individualized for the patient's circumstances.
Where is the procedure performed and who performs this procedure?
This aortic aneurysm treatment procedure is performed in the hospital surgical suite by a vascular surgeon.
How do I find out if I am a candidate for this procedure?
To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 44508.
How do I prepare for the procedure?
Before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. You may need to discontinue certain medications before the procedure. Your health care team will provide specific instructions to help you prepare for the procedure.
What happens during the procedure?
The surgeon will perform the repair under general anesthesia. After you have been given the general anesthesia, the surgeon will make a long incision in the skin to open the chest or abdomen (depending upon the area in which the aneurysm occurs). The normal segments of the aorta above and below the bulging section is clamped and the aneurysmal segment is opened. Tubes constructed of artificial material, such as polyester, are positioned inside the artery in the region of the aneurysm and fastened in place with sutures or stitches to essentially become a new aorta. This procedure replaces and repairs the area of the diseased aorta.
How long does the procedure last?
The procedure itself generally takes three to four hours, but the preparation and recovery time add several hours. The surgery may require a minimum hospital stay of five to 10 days. Some patients may require a stay at a rehabilitation facility to regain their independence. Full recovery may take from four to six weeks.
What happens after the procedure?
Your surgeon will give you specific instructions you need to follow after the surgery until your incision heals adequately. Restrictions may include:
- No driving until approved by your physician (usually within one to two weeks after the procedure, when you are no longer taking pain medication)
- No baths until the incisions heal; showers and sponge baths around the incision are permitted
- Avoid lifting more than 10 pounds for approximately four to six weeks after the procedure
Risks / Benefits
What are the risks and potential complications of the procedure?
Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you. Your physician should discuss both open and endovascular options with you, and should present the risks and benefits of both of these types of procedures so you understand your options completely. In some instances, open surgery may not be an option, while for other patients, endovascular repair may not be feasible.
This is generally a very safe procedure. However, as with any surgical procedure, there are risks. Complications after traditional aneurysm surgery may include heart-related problems, swelling or infections at the site, or respiratory or urinary infections. More serious problems are rare but may include colon problems, kidney problems, or even more rare, paralysis.
This procedure is safe if the patient is in good health, but for older patients or patients with other significant health problems such as a bad heart or lung disease, they may want to consider the minimally invasive option as advised by their physician. Factors such as age, high blood pressure and smoking also prolong recuperation following surgery.
Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended. Learn more about outcomes for this procedure at Cleveland Clinic.
Are there any side effects of the aortic aneurysm treatment?
As with any surgical procedure, you will feel somewhat tired for a few weeks. You will have some discomfort in the area of the incision, but will be given pain medication to relieve this. Many patients will have a diminished appetite for several weeks, and a number of patients may lose up to 20 pounds around the time of the surgery and recovery. It is important to stay active during this time and to continue to try to get up and around after leaving the hospital.
Results of the procedure
Your doctor will discuss the results of the procedure with you. Traditional surgery produces very good outcomes: Patients on average live as long as they would have with no aneurysm. Patients with aneurysms in general should adopt a healthy lifestyle, such as watching their diet and maintaining a routine exercise regimen. These individuals have an increased risk of heart disease and atherosclerosis, and a full evaluation of their risk profile for these diseases should be carried out in conjunction with the aneurysm repair.
- VascularWeb (Society of Vascular Surgeons)