The aorta is the largest artery in the body. The abdominal portion of the aorta carries blood to the abdomen, pelvis, and legs. Sometimes the walls of the aorta weaken and bulge in one area. This is called an abdominal aortic aneurysm (AAA). AAAs are most often caused by atherosclerosis, also known as hardening of arteries, and high blood pressure.
Surgery to repair an AAA is often done when the aneurysm:
Preventive AAA surgery generally has a good outcome for people who are relatively healthy. Emergency surgery to fix an AAA rupture has a much lower survival rate, due to the rapid loss of blood.
Your doctor will review a list of possible complications, which may include:
Some factors that may increase the risk of complications include:
The procedure varies. It can be done before a rupture as a preventive measure or after a rupture on an emergency basis. The preventive procedure is outlined here.
Your doctor may need detailed pictures of your abdomen, heart, and lungs. These can be made with:
Your doctor may also need a record of your heart activity. This can be made with an electrocardiogram.
Your doctor may ask you to see a cardiologist—a doctor who specializes in heart conditions. The cardiologist will check your heart before surgery.
You may need to stop taking certain medications 1 week before surgery. Talk to your doctor about your regular medications.
On the day of the procedure, you will be given an antibiotic by IV. You may also be given a laxative or enema to clear out your bowels.
General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.
This may be done as an open surgery or using an endovascular approach.
In an open surgery, an incision is made from the breastbone to below the belly button. The aorta is clamped slightly above and below the aneurysm. Any blood clot on the inside of the aorta is removed. An artificial wall is used to strengthen the area. This is called a graft. The graft will be stitched to the normal aorta on either side. Then, the clamps are removed. The wound is closed with stitches.
For the endovascular repair, a small incision will be made in your leg. A sleeve will be inserted in this incision and into the aorta. It will be advanced to the aneurysm. The sleeve will take pressure off the wall and prevent it from expanding or leaking. The incision will then be closed.
Anesthesia prevents pain during the procedure. Most people will be sore after the procedure and will be given pain medications.
The length of your hospital stay depends on your overall condition. Ask your doctor how long you should plan to stay.
While you are recovering at the hospital, you may receive the following care:
When you return home, do the following to help ensure a smooth recovery:
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
In case of an emergency, call for emergency medical services right away.
National Heart, Lung, and Blood Institute, NIH
The Society for Vascular Surgery
The Canadian Society for Vascular Surgery
Heart and Stroke Foundation of Canada
Abdominal aortic aneurysm (AAA). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114361/Abdominal-aortic-aneurysm-AAA. Updated August 29, 2016. Accessed October 7, 2016.
Hall SW. Endovascular repair of abdominal aortic aneurysms (Home Study Program). AORN Journal. 2003;77(3):630-642.
6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114361/Abdominal-aortic-aneurysm-AAA: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
7/17/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114361/Abdominal-aortic-aneurysm-AAA: Reis SP, Majdalany BS, AbuRahma AF, et al. ACR Appropriateness Criteria for pulsatile abdominal mass, suspected abdominal aortic aneurysm. Available at: https://acsearch.acr.org/docs/69414/Narrative. Updated 2016.
Last reviewed March 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.