There are two types of aortic aneurysm surgery. Conventional surgical repair involves an incision into the chest or abdomen to have direct visualization of the aneurysm. The National Heart Lung and Blood Institute says endovascular repair is the other surgical option. However, not all aneurysms can be repaired by this method due to size or location. Endovascular repair is a less invasive procedure with a shorter recovery period. But both procedures share similar complications.
Bleeding
Bleeding occurs during or after the surgical repair. During conventional surgery, the surgeon makes an incision through the chest or abdomen and the aorta. Bleeding is normally well controlled with cauterization and clamps; however, the potential for hemorrhage exists if the arterial clamps don't hold properly.
The Society of Thoracic Surgeons warns that endovascular procedures pose the risk of bleeding following surgery. For this reason, patients who undergo endovascular surgery have regular follow-ups to check for bleeding. Blood may seep around the graft if a poor seal exists between the graft and the aorta. The graft may tear the artery wall, causing bleeding into the abdominal cavity.
Ischemia
Ischemia means a lack of blood flow to tissues. During aortic aneurysm surgery, the aorta is clamped. Blood flow to the body below the aneurysm is diminished during surgery. Conventional aortic aneurysm surgery takes approximately three to four hours. Marion Soat, MSN, CCNS, reported in her article in the 2009 "American Nurse Today" that abdominal organs such as the kidneys and colon can be damaged by the prolonged, decreased blood flow. Kidney failure and necrotic bowel may occur. A patient's arms, legs and spinal cord may also be damaged from decreased blood flow, causing loss of function and paraplegia.
Heart Attack
Surgeons keep a patient's blood pressure low during aortic aneurysm surgery. Low blood pressure decreases oxygen rich blood flow to the heart. The heart muscle can be damaged from not enough oxygen, and the patient may experience a heart attack during or following surgery.
Infection
The chest, abdomen or groin site from endovascular surgery are vulnerable to infection following surgery. Once discharged, patients observe for and report to the physician any fever or redness, swelling, tenderness or discharge at the surgical sites.
Patients are at risk for developing pneumonia following surgery. The pain from chest and abdominal incisions prevents patients from taking deep-cleansing breaths. To decrease the risk of infection, patients cough and deep-breathe every couple of hours during recovery to remove secretions and stale air from the lungs. Once home, patients should report fever, cough, shortness of breath or chest pain to a doctor. These are symptoms of pneumonia.
References
- National Heart Lung and Blood Institute: "Aortic Aneurysm: Treatments"
- The Society of Thoracic Surgeons: "Aortic Aneurysm"
- "American Nurse Today"; Aortic Aneurysm: Causes, Clues, and Treatment Options; Marian Soat, MSN, CCRN; July/August 2009
