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Questions about surgery for an abdominal aortic aneurysm


Questions about surgery for an abdominal aortic aneurysm

I was just diagnosed with a 4 cm abdominal aortic aneurysm, and I am otherwise healthy. Shouldn't I repair the aneurysm now, before it expands? I may not be a good surgical candidate later.

The decision you and your doctor make will be based on your condition, the risk of death or injury the aortic aneurysm poses, and the risks of surgery. The operation is not without risks, with a significant chance of injury or death. And many doctors prefer to avoid these risks unless the operation will result in a definite survival benefit.

Overall, experts feel that the chance of a rupture of a 4 cm aneurysm is low and that it is in your best interest to monitor the aneurysm and repair it if it gets larger.

How long will I be in the hospital after my operation?

If you are healthy and have a smooth operative and postoperative course, you can expect to be in intensive care (ICU) or under another type of post-surgery care for 24 hours and in the hospital for 5 to 10 days. If there are complications, you may have to stay longer in the hospital. If you have an endovascular repair procedure, your hospital stay and recovery time will be shorter.

After you have returned home, it may take as long as 6 months to fully recover from open surgery for an abdominal aortic aneurysm. You should follow up with your surgeon about a week after leaving the hospital. At this meeting you and your doctor will decide on future meetings and talk about when you can return to work, drive, and resume other activities.

While at home, you will at first feel tired and weak. You will likely need help in many daily activities. And you may benefit from short-term placement in a rehabilitation center. You should do no heavy lifting, as this may lead to a hernia. But you should begin walking 2 to 3 days after returning home. You will likely need pain medicine.

Most people who have abdominal aortic aneurysm surgery recover well.

Will I have erection problems after the operation?

Erectile dysfunction, caused by injury to the nerves located next to the abdominal aorta, sometimes occurs. Sometimes men have erectile dysfunction (impotence) temporarily after surgery, but function is later regained. But for others, erectile dysfunction is permanent.

I have cancer. Should I have surgery for an abdominal aortic aneurysm?

This is a question for you and your doctor to decide. Together, you can weigh the risk of rupture against how long you are expected to live. Surgery may make sense if you are expected to live longer than 2 years.

I have kidney disease. How will this affect my outcome?

Those with kidney disease have a higher risk for complications during surgery for abdominal aortic aneurysm. If you are on dialysis, your situation needs to be looked at carefully, and you may need special monitoring at the time of surgery. If you have chronic renal failure but are not on dialysis, you need to be monitored very closely in the days before and after the operation, as there is the chance you will suffer some kidney damage during the operation and may require dialysis in the postoperative period. You may also be at increased risk for postoperative bleeding. But the surgery should still be considered if the aneurysm meets operative criteria.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerDavid A. Szalay, MD - Vascular Surgery
Last RevisedJanuary 26, 2010

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