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| SURGERIES OF THE HEART |
Aneurysmectomy
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Aneurysmectomy is the repair or removal of an aneurysm, which is a weakened, abnormal out pouching within the wall of the aorta. The aorta is the body's largest artery, which originates in the heart and has many branches to deliver blood throughout the body.
The procedure is also called as Aortic Aneurysm Repair or Aortic Aneurysm Removal.
REASONS FOR THE PROCEDURE
* To prevent rupture of an aneurysm, which would cause severe, life-threatening bleeding.
* To remove a ruptured aneurysm and repair the damaged aorta
RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE
* Emergency surgery due to a burst aneurysm
* Severe hemorrhage
* Low blood pressure
* Shock
* Cardiovascular disease, including angina or a previous heart attack
* Cerebrovascular disease, including previous episodes of transient ischemic attacks
* Pre-existing lung disease
* Debilitation due to cancer
* Diabetes
* Obesity
BEFORE THE PROCEDURE
The doctor will likely do some or all of the following:
* Physical Exam
* Blood Tests
* X-rays
* Ultrasound – a test that uses sound waves to find the aneurysm
* CT Scan – a type of x-ray that uses a computer to make pictures of the inside of the body
* MRI Scan – a test that uses magnetic waves to make pictures of the inside of the body
* Cardiac Catheterization – the insertion of a tube-like instrument into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply
* Electrocardiogram – a test that records the heart's activity by measuring electrical currents through the heart muscle
In the days leading up to the procedure:
* The night before, eat a light meal and do not eat or drink anything after midnight
* The patient may be given laxatives and/or an enema to clean out the intestines
* The patient may be asked to shower the morning of the procedure, and may be given special antibacterial soap to use
* Arrange for help at home after returning from the hospital
* Arrange for a ride to and from the procedure
DURING THE PROCEDURE
* IV fluids
* Sedation
* General Anesthesia
* A breathing tube will be used during surgery but will be removed when the patient gets awaken from the anesthetic
* The patient may require a tube through the nose and into the stomach to remove accumulated stomach acid and fluids
* The patient may require a catheter in the bladder until a few hours after the operation is completed
PROCEDURE
- Depending on the exact location of the aneurysm, blood flow may need to be diverted to a heart-lung machine, which will temporarily do the jobs of providing the blood with oxygen and circulating the blood through the body.
The surgeon makes an incision in the abdomen or chest, over the area of the aneurysm. The aorta is clamped above and below the aneurysm. The surgeon opens the aneurysm, cleans out any debris, and then sews a dacron tube (graft) in place to reconnect the two ends of the aorta. The tissue of the aneurysm is then wrapped around the outside of the graft.
When the graft is properly in place, the clamps are released, allowing blood flow to resume through the aorta. The incision is closed, using either stitches or staples, and covered with a sterile dressing.
AFTER THE PROCEDURE
The patient will need to stay in the intensive care unit for the first day or so after surgery so that the vital signs can be carefully and continuously monitored; and then the patient will be moved to a regular hospital room.
TIME TAKEN FOR THE PROCEDURE
About one hour
POSSIBLE COMPLICATIONS
* Severe bleeding
* Kidney failure
* Respiratory distress
* Heart attack
* Stroke
* Infection
* If blood circulation is cut off to the limbs or intestines, these tissues could be deprived of oxygen, leading to tissue death
* Damage to nerves in the area, leading to sexual problems (such as impotence)
* Blood clots and complications if these blood clots break off and travel through the circulatory system
* Death.
The chance for complications is greatly increased when the operation is done on an emergency, rather than a planned, basis.
POSTOPERATIVE CARE
Monitoring the Condition. The patient will be hooked up to monitors to track the heart rate, breathing, blood pressure, and blood oxygen levels for the first day or two after surgery. Also, the surgeon may order blood tests, chest x-rays, EKG, and ultrasound of the repaired area of the aorta.
Dealing with Nausea. The patient may be nauseated for a few hours after surgery. Depending on various factors, the surgeon may place a nasogastric tube through the nose and into the stomach to drain accumulated fluids and stomach acid. The patient won't be able to eat or drink until this is removed.
Preventing Blood Clots. The patient may be given special compression stockings to wear after surgery to decrease the possibility of blood clots forming in the legs.
Improving Lung Function. The patient may be asked to use an Incentive Spirometer, to breathe deeply, and to cough frequently, in order to improve lung function after general anesthesia.
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| Last Modified :
Tuesday, May 12, 2009 |
Compiled and edited by the Editorial team and
approved by Expert panel of h4heart.com
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