What's the treatment for abdominal aortic aneurysm?
Treatment of abdominal aortic aneurysm depends upon the size of the aneurysm. If the aneurysm is less than 4 cm (1.5 in) wide, surgery is not necessary, but your doctor will monitor it carefully for an increase in size. Aneurysms between 4 and 5 cm (1.5 - 2 in) wide may be treated with surgery if you and your doctor determine that is the best course of treatment.
Aneurysms that are larger than 5 cm (2 in) or are causing symptoms are always treated with surgery, unless it is considered risky because of other health problems. The surgeon makes an incision in the abdomen, removes the aneurysm, and repairs it with a synthetic patch, called a graft. This type of surgery has a very high success rate. There is also another type of surgery called endovascular grafting, which involves inserting a thin tube called a catheter through a groin artery into the abdominal aorta. The catheter's tip holds a deflated balloon that is covered by a tightly folded graft. When the catheter is in position, the balloon is inflated, which causes the graft to open to span the length and width of the aneurysm. Devices at each end of the graft secure it to the inner wall of the aorta to strengthen the wall and prevent it from rupturing. This surgical method may not be available at all hospitals at this time and is only used for non-emergency repairs. Emergency surgery is performed when the abdominal aortic aneurysm has ruptured or is about to rupture. Because a ruptured aneurysm causes internal bleeding, there is a risk of damage to internal organs, such as the kidneys, because their blood supply is interrupted. If a ruptured abdominal aortic aneurysm is not treated, it always results in death.
Surgical treatment of abdominal aortic aneurysm has been performed routinely for almost 50 years and is one of our most successful and durable operations. In surgery the diseased part of the aorta is replaced with a Dacron or Teflon graft that is carefuly matched to the normal aorta and sewn in place by the surgeon. While ultimately curative, this is an operation that requires a major abdominal incision and general anesthesia, and the hospital stay averages 7-10 days for most patients. Even after uncomplicated surgery, it is often 6-8 weeks before patients can return to a full and normal life. Recent advances in catheter-based technologies have led to groundbreaking treatments for aortic aneurysms.
Now, endovascular grafting technology allows surgeons to repair the abdominal aortic aneurysm by delivering a bypass graft through a small incision in the groin, rather than the traditional major open surgery. The endovascular method, approved by the FDA in the fall of 1999, allows the tightly wrapped graft to be delivered via a catheter (tube) inserted in a groin artery. In the operating room, using x-rays for proper positioning, the graft is secured in place by inflating a balloon to expand the graft to the size needed to prevent blood flow into the aneurysm. For most patients, the hospital stay is only overnight, with a return to work or normal daily activities in about a week. Even patients with multiple medical problems, once thought "too sick to undergo traditional abdominal aortic aneurysm repair," can have their abdominal aortic aneurysm repaired with an endovascular method, and often be home the next day.
Endovascular repair of abdominal aortic aneurysm is being performed routinely at the Maryland Vascular Center. A select team of physicians including vascular surgeons and interventional radiologists provide a multidisciplinary approach to treatment and the special skills necessary to handle the most complex problems. If you have an aortic aneurysm and you are in good health, some consideration should be given to elective repair.
More information on aortic aneurysm and other aortic valve diseases
What is an aortic aneurysm? - An aortic aneurysm is a localized dilatation or aneurysm of the aorta, usually representing an underlying weakness in the wall of the aorta at that location.
What causes an aortic aneurysm? - Most aortic aneurysms occur in the abdominal aorta, the main cause being arteriosclerosis. There is a familial tendency to aortic aneurysms.
What're the symptoms of aortic aneurysm? - Most intact aortic aneurysms do not produce any symptoms. The ballooning of the aneurysm does not cause any symptoms unless it becomes large enough.
What're the complications of aortic aneurysm? - Half of all persons with untreated abdominal aortic aneurysms die of rupture within 5 years. Spontaneous blockage of the aorta can also occur.
How is aortic aneurysm diagnosed? - Aortic aneurysms can be diagnosed from their symptoms. An ultrasound scan is the easiest way to detect an aortic aneurysm.
What's the treatment for aortic aneurysms? - Medical therapy of aortic aneurysms involves strict blood pressure control. Symptomatic aneurysms require surgical treatment to prevent complications.
What's an abdominal aortic aneurysm (AAA)? - An abdominal aortic aneurysm (AAA) is a bulge in the aorta in abdomen. Most AAAs occur in association with advanced atherosclerosis.
What're the symptoms of abdominal aortic aneurysm? - Symptoms of abdominal aortic aneurysm include a pulsing sensation in the abdomen, and pain ranging from mild to severe.
How is abdominal aortic aneurysm diagnosed? - Because abdominal aortic aneurysms may not cause any symptoms at the beginning, they are diagnosed by chance during a physical examination.
What's the treatment for abdominal aortic aneurysm? - Treatment of abdominal aortic aneurysm depends upon the size of the aneurysm. Surgical treatment of abdominal aortic aneurysm is often preformed.
What is aortic valve disease? - An aortic valve disorder usually does not cause any symptoms in its early stages. Infection on an abnormal aortic valve leads to a disease called infective endocarditis.
What is aortic insufficiency? - Aortic insufficiency is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole.
What's aortic valve regurgitation? - Aortic valve regurgitation develops hen the valve leaflets fail to close properly during the heart's relaxation phase.
What causes aortic valve regurgitation? - Causes of aortic valve regurgitation include being born with a defective aortic valve, wear and tear from aging, infection of the lining of the heart.
What're the symptoms of aortic regurgitation? - Symptoms of aortic regurgitation include chest pain, excessive sweating, palpitations, shortness of breath that worsens with exertion or lying down.
How is aortic valve regurgitation diagnosed? - A doctor diagnoses aortic valve regurgitation by hearing a heart murmur or other abnormal noises when listening with a stethoscope.
What're the treatments for aortic regurgitation? - Medicines to improve the pumping action of the heart may be given to reduce the severity of the regurgitation. Valve replacement surgery is usually recommended.
What is aortic stenosis? - Aortic valve stenosis is a heart condition caused by narrowing of the aortic valve. Aortic stenosis is the inability of the aortic valve to open completely.
What causes aortic stenosis? - Congenital aortic stenosis is caused by improper development of the aortic valve in the first 8 weeks of fetal growth. Age related calcification of the valve is the most common cause.
What're the symptoms of aortic stenosis? - Symptoms of aortic stenosis include shortness of breath (dyspnea), passing out (syncope), and chest pain (angina pectoris).
How is aortic stenosis diagnosed? - Aortic stenosis is often diagnosed due to the presence of a heart murmur. The gold standard for diagnosis is an echocardiogram.
What's the treatment for aortic stenosis? - Patients with mild aortic stenosis do not require treatment. Valve replacement surgery is indicated for patients with severe aortic stenosis.
Aortic valve replacement surgery - Aortic valve replacement surgery is an open heart procedure for treatment of narrowing (stenosis) or leakage (regurgitation) of the aortic valve.