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Fall 2012 - The End of Long Recoveries After AAA Repair

It’s frightening but true: Approximately 80 percent of individuals who suffer a ruptured abdominal aortic aneurysm (AAA) die before they can receive treatment. But, when AAAs are detected early (and they often are), repairing such a potentially life-threatening condition can be quite uncomplicated for patients.

The large blood vessel that supplies blood to the legs and abdomen is called the aorta. An AAA occurs when a section of the aorta balloons out.

AAAs typically take many years to expand and rarely cause symptoms AAAs are typically found incidentally during an X-ray, ultrasound or CT scan performed for some unrelated reason. Occasionally, an aneurysm is fi rst suspected during a regular exam with your primary care physician.

During the exam, the doctor may notice a lump, a pulsation or rigidity in the abdomen and order an ultrasound of the abdomen to confi rm an AAA is present. If an AAA is detected, a CT scan will then help the physician determine the size of the aneurysm and the best treatment strategy.

  H2H - Fall 2012 AAA

To perform the procedure, cardiologist working in conjunction with a vascular surgeon, makes a small incision in the patient’s groin area and threads a catheter through the femoral artery and into the aorta to the site of the aneurysm. Attached to the catheter is an endograft, a fabric covered metal stent. Once the endograft reaches the aneurysm, the endograft is released to protect the aneurysm from rupture.

Not all aortic aneurysms require intervention. If they are very small, yuor physician may watch them to see if they enlarge or grow rapidly. Many aneurysms stay stable for years. If an AAA grows larger than 5.0 to 5.5 cm, then repair is necessary.

The endografting procedure is the preferred method of AAA repair for patients who qualify for it.

The discomfort and blood loss associated with the endograft procedure are minimal. Patients typically go home within 24 hours and are back to work or their usual activities within a couple of days.

The endograft patient’s experience is markedly different from the traditional surgical experience. If a patient is not anatomically suited for endograft placement, traditional open surgical repair is necessary. This approach requires a large abdominal incision. A vascular surgeon then repairs the aneurysm using a graft made of synthetic material and often performs a bypass procedure to the legs. Traditional AAA surgical repair means a four- to six-week recovery for patients. These patients do experience discomfort and limited mobility throughout a portion of the recovery period.

Recent studies have determined that patients do equally as well long-term with the endograft procedure as compared to open surgery.

Though it is rare, AAAs may rupture. This is a true medical emergency that requires immediate intervention. In the past, surgery was the only option. Now, endografting can often be performed and may increase survival. If you or someone you know experiences the following sudden symptoms, call 911 immediately.

  • Severe, constant pain in abdomen or back.
  • Rapid heart rate
  • Nausea and vomiting
  • Dizziness
  • Shock

AAAs can develop in people of all ages and genders, but they are most prevalent in men older than 60. Other AAA risk factors include:

  • Emphysema
  • Genetic factors
  • High blood pressure
  • High cholesterol
  • Smoking
  • Obesity

The U.S. Preventive Task Force recommends that men who smoked at any time in their lives should have a screening AAA ultrasound between the ages of 65 and 75. Others who are high risk may also benefi t from a screening.

If you have questions about abdominal aortic aneurysm, talk to your doctor.

This article originally appeard in Heart to Heart magazine a magazine spacifically for heart patients and their families. Subscribe to Heart to Heart Magazine