Under the surgical treatment of aneurysms of the aorta refers to its excision and replacement of the remote (aneurysmal) aorta plot the synthetic prosthesis. Aneurysm is a special extension saccular wall of the aorta, which arises due to thinning of the wall. This occurs when the aortic wall affected by any inflammatory process or atherosclerosis. Aneurysm - a serious problem, since an increase in its growth and increases the risk of its most feared complication - rupture. In addition, complications, and aortic aneurysm occurs and the phenomenon of blood clots and enters them in various organs and tissues, where the occlusion of the vessel. Fortunately, aneurysms can be treated. There are several methods of treatment of an aortic aneurysm, so that if you do not fit one method, it is possible, fit the other. That such methods as a public method (or surgical) and endovascular (stent method). Choice of treatment of the aneurysm is dependent on many factors such as size, location and shape of the aneurysm, as well as the general condition of the patient.
An aneurysm may be located in the arteries of any caliber, but more often they occur in the aorta. Depending on the aorta, where the aneurysm, it is called an aneurysm of the abdominal aorta or thoracic aorta. In addition, the aneurysm may be located in the arteries of the hip, knee, spleen, liver, kidneys or stomach. But the most common type of aneurysm - an aneurysm is the abdominal aorta.
Not all aneurysms require immediate treatment. If the aneurysm is small in size, the doctor may suggest watchful waiting.
When the aneurysm reaches life-threatening size, your doctor may offer you surgery. The operation of an aneurysm is performed under anesthesia. As mentioned, the treatment may be either replacement of the affected area of the aorta graft, or stent. Sometimes, surgery for an aneurysm is the so-called clipping, that is, when anevrzima, sticking out like a sack on one side of the aorta, pinched at the base of a special clip.
Preparing for surgery for aortic aneurysm
Before surgery, the doctor usually collects all necessary data about the course of the patient. This is his complaint, when they occur, how long they bother the patient. Additionally, a doctor conducting a survey, which is gentle palpation of the aneurysm and places proslushyvanie with phonendoscopes. Be sure to pre-operative holding of additional methods, such as:
ultrasound scan
computed tomography
magnetic resonance angiography
angiography
Before surgery, the doctor will recommend you not eat for 8 hours. Also, if you are taking any medication, you should discuss with your surgeon about their future reception before and after surgery.
When should treatment of an aortic aneurysm?
Treatment of an aneurysm of the aorta can be planned and emergency, for health reasons. Elective treatment is carried out when the aneurysm reaches a certain size, depending on the location of the aneurysm, or if it is growing rapidly. Less commonly, planned treatment of aneurysms should be subject to the fact that it breaks the blood flow in the legs.
Emergency treatment of an aortic aneurysm is required when zhizneugorzhayuschih states, such as the threat of rupture or separation, or an accomplished break. Also, emergency treatment may be carried out when a severe pain in the abdomen or back, indicating that the separation of the aneurysm.
Is there a risk during surgery for an aortic aneurysm?
Serious health problems are particularly common in elderly patients, may increase the risk of complications during surgery for an aortic aneurysm. In the absence of comorbidity older age of the patient is not a contraindication to surgery. The risk of complications during surgery increased in the following related illnesses:
congestive heart failure
diabetes mellitus
chronic obstructive pulmonary disease, when there are violations of pulmonary ventilation
angina
The physician should evaluate the presence of these risk factors before surgery.
How is the surgery for an aortic aneurysm?
Usually surgery is performed under general anesthesia. Depending on the location of the aneurysm (aorta, the artery knee, etc.) can be cut in the abdomen, legs or other areas.
Once the surgeon reaches the location of the aneurysm, he grasps the upper section of the artery or the aorta, the blood does not enter the aneurysm. Thus, the surgeon can either remove the modified portion of the aorta and replace it with a synthetic graft or sew into the lumen of the aneurysm graft or excise the aneurysm, previously put it on its base clip (in case of an aneurysm forms in the form of lateral protrusions).
In some cases where the aneurysm is located in the small arteries, such as in arteries of legs, the surgeon may remove part of the artery and replace it with a section of vein.
Less commonly, the surgeon can not clipped aneurysm because of its location, the so-called sealing is performed by means of a metal or plastic. This type of operation subject with the help of a catheter introduced into the vessel. Fills the lumen of the aneurysm filling and prevents it from filling with blood.
After the surgery, depending on its size, the patient needs rehabilitation period for a period of 7 to 10 days.
Complications after surgery for aortic aneurysm
As after any surgery, after surgery for an aortic aneurysm can be complications. They include: complications of the heart complications of lung complications of renal complications of the bowel
Additionally, there may be an infection of the surgical wound, urinary tract and lungs. It is very rare because of the spread of blood clots in the vessels of the surgical site may be strokes and paralysis. Also, such a complication occurs as retrograde ejaculation (in men), when the sperm to vas deferens goes back to the seminal vesicles. It should be noted that these complications are associated mainly with emergency interventions aneurysm. Prevention of aneurysm
To achieve maximum results after surgery for an aortic aneurysm, change their way of life. First of all, it is necessary to normalize blood pressure and cholesterol, since they are major risk factors for aneurysms. Activities aimed at this: consumption of a diet low in cholesterol of exercise no smoking normalization of body weight