Download Abdominal Aortic Aneurysm Repair

0072/05/Oct 2009
Surgical Directorate
Abdominal Aortic Aneurysm Repair
What is an Abdominal Aortic Aneurysm Repair?
This is an operation to repair/replace a stretched and weakened section of the main artery
(Aorta) in your abdomen with an artificial blood vessel made of plastic.
What are the alternatives?
There is no alternative treatment for this condition although smaller aneurysms (less than 5.5
cms in diameter) can be observed by repeat scans every six to 12 months as the risk of rupture
is very small.
What are the potential risks and side effects?
Any operation may lead to complications and these include the following:
 Excessive bleeding and injury to nearby areas.
 Infection.
 Allergic reaction to drugs or anaesthetic.
 A recurrence of the problem.
 Breathing difficulties.
The likelihood of complications increases in:
 People over 60.
 People who are overweight, smokers or heavy drinkers.
 People who take certain medication and so called recreational drugs.
Aortic grafting in particular is a major operation and full recovery takes several weeks. Aortic
surgery does carry a risk of death because of the strain it can place on the heart. However the
overall risk from an untreated aneurysm is greater.
Aortic surgery can also cause loss of blood flow to the arteries leading to damage to the area
they feed. These can involve:
 Spinal nerves causing paralysis.
 The intestines causing gangrene of the bowel.
 Kidneys causing kidney failure.
 Legs and feet causing loss of one or more toes.
As with any major operation there is a risk of chest infection following surgery, particularly if you
are a smoker. There is a very small risk of you having a complication such as a heart attack,
pulmonary embolism or deep vein thrombosis (blood clot to the lungs or legs), wound infection
or haemorrhage (bleeding). Whilst every care is taken to avoid it, the nerves that affect your
sexual organs may be damaged during surgery.
Occasionally the bowel (gut) is slow to start working again but following a period of rest, with
fluids provided through a drip, your bowels will get back to normal.
© East Sussex Hospitals NHS Trust – www.esht.nhs.uk
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Sexual activity can also be affected as nerves in your abdomen may have to be cut during the
operation.
The risks associated with surgery and having an anaesthetic will be discussed with you in full by
your Doctor/Surgeon prior to asking you to sign a consent form.
Although you will sign a consent form for this treatment, you may at any time after that
withdraw such consent. Please discuss this with your medical team.
What are the expected benefits of treatment?
If the weakness is repaired before it ruptures, there is a high overall chance of successful repair
and a return to normal life expectancy. Many people who have had aortic surgery recover well
and have no serious complications.
What should I do before I come into hospital?
In most cases, you will be sent directly from your consultation to the pre-admission assessment
clinic or the day surgery unit where you will be seen by a nurse and/or a doctor.
This appointment will assess your fitness for operation and provide an opportunity to discuss
aspects of your operation.
You will also receive advice on what medications you should take, any preparation procedures
required i.e. blood tests, ECG (heart recording), x-ray etc and also advice about when you
should stop eating and drinking prior to the operation.
If it is not possible to see you in the pre admission clinic on this visit you will receive an
appointment for another day prior to your operation.
Will I have an anaesthetic?
This operation is performed under General Anaesthetic - where you are asleep during the
procedure.
The anaesthetist will discuss this in full with you.
How will I feel afterwards?
You will usually be taken to the intensive care/high dependency unit immediately after your
operation for close monitoring.
You will have a drip to ensure that you receive adequate fluids and a urinary catheter to enable
the nursing staff to monitor how much urine you pass.
You will also have a tube which passes up through your nose and down into your stomach to
prevent you feeling sick - this will be removed as soon as your bowel starts to work or sooner if
appropriate.
© East Sussex Hospitals NHS Trust – www.esht.nhs.uk
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The doctors and nursing staff looking after you will try to keep you pain free by giving pain killers
by injection, via a tube in your back (epidural) or by a machine that you are able to control
yourself by pressing a button (Patient Controlled Analgesia - PCA).
There will be a dressing on your wound and you may have a drainage tube which will be taken
out after a few days.
Fluids and food will be introduced gradually as your bowel starts to work again - the timing for
this varies with each person.
You will be given assistance to get out of bed and up and about as soon as you are able - this is
to help prevent complications following your operation i.e. blood clots in the legs, bed sores and
urine infection.
A physiotherapist will visit you to advise on breathing exercises to prevent you getting a chest
infection and to help with your walking.
You can expect bruising around your wound; this is quite normal and will gradually fade.
How long will I be in hospital?
You are likely to be in hospital for one week to 10 days after your operation however, this varies
from person to person and will depend on your personal recovery.
What should I do when I go home?
You will be given pain killers to take home from hospital.
You will feel tired for some weeks after the operation but this should gradually improve as time
goes by.
You will be safe to drive when you are able to perform an emergency stop. This will normally be
at least four weeks after surgery.
You will be able to bathe or shower as normal.
You should avoid heavy lifting or straining for six weeks after the operation.
If you were previously a smoker you must make a sincere and determined effort to stop
completely. Continued smoking will cause further damage to your arteries and your graft is
more likely to stop working.
You can also help by improving your general health by taking regular exercise, reducing weight
and eating a low fat diet.
© East Sussex Hospitals NHS Trust – www.esht.nhs.uk
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Will I have to come back to hospital?
A practice/district nurse referral will be made for you if your stitches need to be removed (ie. are
not dissolvable).
You will also be sent an outpatient appointment for four to six weeks to be reviewed in clinic.
When can I return to work?
Depending on the type of work you do, you should be able to return within one to three months.
Please remember to ask for a medical sick certificate when you come in to hospital to avoid
delays in your discharge.
Other sources of information
Association of Anaesthetists - www.aagbi.org - “You and your Anaesthetic”
The Royal College of Surgeons - www.rcseng.ac.uk
Contact information – Before Surgery
Conquest Hospital
Pre-assessment Unit
Telephone: (01424) 755255 ext 7228 or 8119
Eastbourne District General Hospital
Firle Unit (Pre-assessment Unit) Telephone: (01323) 417400 ext 4153
Contact information – After Surgery
Your GP
NHS Direct
www.nhsdirect.nhs.uk
Telephone: 0845 4647
Important information
Please remember that this leaflet is intended as general information only. It is not definitive.
We aim to make the information as up to date and accurate as possible, but please be warned
that it is always subject to change. Please, therefore, always check specific advice on the
procedure or any concerns you may have with your doctor.
Hand Hygiene
In the interests of our patients the trust is committed to maintaining a clean, safe environment.
Hand hygiene is a very important factor in controlling infection. Alcohol gel is widely available
throughout our hospitals at the patient bedside for staff to use and also at the entrance of each
clinical area for visitors to clean their hands before and after entering.
© East Sussex Hospitals NHS Trust – www.esht.nhs.uk
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Other formats
If you require this leaflet in any other format such as larger print, audio tape, Braille or an
alternative language, please ask at one of our PALS offices.
If you require interpreting services during your hospital visit please ask a member of staff who
will be able to organise this for you via the appropriate department.
After reading this information are there any questions you would like to ask? Please list below
and ask your nurse or doctor.
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Reference
The following clinicians have been consulted and agreed this patient information:
Consultant Surgeons
Mr P Rowe
Mr S Whitehead
Mr A Sandison
Mr G Evans
Mr G Khoury
Mr A Aldridge
Mr J Lyttle
Clinical Matrons
Mrs E Fellows
Mrs J Kinch
Senior Sisters
Linda Budd
Gillian Churchill
Date Agreed:
Review Date:
Responsible Clinicians:
October 2009
October 2011
Mrs E Fellows and Mrs J Kinch - Clinical Matrons
© East Sussex Hospitals NHS Trust – www.esht.nhs.uk
Trish Shult
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