Abdominal Aortic Aneurysm

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The aorta is the main blood vessel that carries blood from the heart to the rest of the body. It starts in the chest and runs down into the abdomen, where it branches into the iliac arteries. The iliac arteries carry blood to the lower parts of the body and to the legs. Sometimes, with aging or other changes, a section of the aorta may weaken and begin to bulge.

This bulge can get larger over time as the walls of the aorta get thinner and stretch like a balloon. This bulge in the aorta is called an aneurysm.

Sometimes an aneurysm occurs in the part of the aorta that runs through the abdomen(the stomach). This is called an abdominal aortic aneurysm (AAA).

Is this a serious condition ?

In the early stages, when an AAA is small, it may not be an immediate heath risk. However, your doctor will want to check its condition regularly. If the AAA continues to grow, the aorta's walls can become thin and less able to stretch. Eventually the stretched sections may become too weak to support the force of blood flow. Such an aneurysm could burst, causing serious internal bleeding.

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What are some of the symptoms of a AAA?

Unfortunately, most patients with a AAA have no symptoms. For people who do have symptoms, the most common one is pain. The pain can be in the abdomen, back or chest. It could be anything from a mild pain to a severe pain or tenderness in the mid or upper abdomen or lower back. Some patients feel the aneurysm as a pulsating or throbbing mass in their abdomen. Many patients feel none of these symptoms, yet may have a AAA. An AAA is often found during an examination done for other medical reasons. Most often, aneurysms are found during a medical test such as a CT scan or ultrasound.
If you know you have an AAA and you develop back pain, chest pain or diziness, call your doctor right away.

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What causes a AAA ?

Overtime, vascular disease, injury or an inherited defect of tissue within the arterial wall can cause the aorta to weaken. Blood pressure against the weakened area can cause it to stretch and grow thinner, like a balloon.
Risk factors for developing an aneurysm include, but may not be limited to, family history, smoking, heart disease, trauma and high blood pressure. If you are at risk for developing an aneurysm, your doctor may suggest periodic checks. The checks could include a physical exam and possibly a CT scan, MRI or ultrasound.

How do doctors treat an AAA ?

When an aneurysm is small, your doctor may recommend periodic checkups to monitor it. If an aneurysm is larger or is rapidly growing, it has more risk of bursting. If your doctor thinks there is a risk the aneurysm may burst, he or she may recommend treatment. There are two types of treatment for AAA...

  • Open Surgical repair
  • Endovascular repair

The goal of all AAA repair is to prevent the aorta from bursting.

Important Note: Not every patient is a candidate for endovascular repair. Open surgical repair and endovascular repair both have advantages and disadvantages based upon each patient's condition and needs. Discuss advantages and disadvantages with your doctor.

What is open surgical repair ?

In this approach, surgery is performed to repair the section of the aorta that has an aneurysm. To reach the aneurysm, a doctor makes a cut through the abdomen or the side of the patient. The doctor repairs the aorta by replacing the aneurysm section with a fabric tube called a 'graft'.

The graft is sewn into place and acts as a replacement blood vessel. The blood flow through the aorta is stopped while the graft is put in place. The surgery takes about 2 to 4 hours to complete.

Open surgical repair is a proven medical procedure that works. However, it also has a long recovery period. Patients usually stay overnight in the intensive care unit and stay another 5 to 9 days in the hospital. Many patients are unable to eat normally for 5 to 7 days after the surgery. The overall recovery period can last upto 3 months.
As with any medical procedure, open surgical repair has a risk of complications. Discuss these with your doctor