An abdominal aortic aneurysm (AAA) is a medical condition in which the wall of the aorta, the main artery that pumps blood from the heart to the rest of the body, weakens and begins to bulge. Many AAA are small enough to require only monitoring and no treatment, but if the aneurysm is too large or growing too fast, treatment becomes imperative. The treatment for an AAA can be a minimally invasive procedure, or a major open-abdomen surgery.
Instructions
1. Talk to your doctor if you notice a pulsating mass in your belly. More likely, your doctor may discover AAA while testing for other health concerns, but often AAA are revealed through an abnormal X-ray. There are typically no symptoms. If your doctor suspects an aneurysm, she may order an ultrasound, magnetic resonance imaging (MRI) or CT (computerized tomography) scan to confirm the diagnosis and measure the aneurysm.
2. Seek a second opinion to confirm the diagnosis and initial treatment plan. The aorta is about 1 inch in diameter. If the aneurysm is less than 2 inches, your doctor will usually recommend monitoring the aneurysm through regular ultrasound exams in order to ensure that it is not growing.
3. Ask your doctor why one treatment is better than another for you. There are two types of surgery for AAA. If the aneurysm is larger than 2.5 inches (5 cm) in diameter, or begins to grow quickly from one exam to the next, your doctor will likely recommend surgery. After that consultation, seek a second opinion before proceeding.
4. Ask your doctor about endovascular surgery, a minimally invasive procedure performed by an interventional radiologist. The surgery for AAA involves the physician making a small incision in your groin, inserting a catheter through it to the site of the AAA, and then through the catheter, positioning a tiny fabric tube called a stent graft within the aneurysm. The stent graft opens up and reinforces the wall of the aorta, so the blood flows through the tube and the weakened aortic wall can heal. This procedure uses sedation and epidural anesthesia, and involves an average hospital stay of about four days, followed by a recovery of about two weeks.
5. Ask about the risks and benefits associated with open-abdomen surgery. This method is often required for large AAA. Under general anesthesia, your surgeon will make a large incision from your breastbone to your pubic area and open your abdomen. He will clamp your aorta above the aneurysm, cut the aneurysm completely out and replace the damaged portion of your aorta with a graft, a tube designed to provide blood with a stronger, safer path. This surgery requires a hospital stay of eight to 10 days, followed by a recovery period of about a month and a half.
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