Abdominal aortic aneurysm (AAA) open repair surgery
An abdominal aortic aneurysm (AAA) is a swelling in the aorta.
The aorta is the largest artery (blood vessel) in the body. It carries blood from the heart to the rest of your body. The abdominal aorta is in your tummy (abdomen).
An AAA can be life-threatening if we do not find it early.
When the aorta stretches, there is a risk of it bursting. The abdominal aorta is usually about 2cm wide. An aneurysm that is 5.5cm or larger might need treatment with surgery to stop it bursting.
You can read more about abdominal aortic aneurysms on the NHS website.
Preparing for surgery
We see you in a pre-assessment clinic to check that you are well enough for the surgery.
We give you information about:
- if you need to stop any medicines or change the amount that you take (the dose)
- stopping eating and drinking before your surgery
- keeping well and improving your health before surgery
How open repair surgery helps
Open repair surgery replaces the weak section of the aorta (the aneurysm) with a piece of manmade tubing (a graft). This operation is successful in most cases. The graft usually works well for the rest of your life.
Your surgeon only recommends this operation if they think that the risk of the aneurysm bursting is higher than the risk of having treatment.
Recovering after surgery
Most people stay in hospital for 5 to 10 days, but everyone is different. You can leave hospital when this is safe.
You see a physiotherapist in hospital to help you get moving again.
There is another operation for an AAA called an endovascular aneurysm repair (EVAR). This is a type of minimally invasive surgery called a keyhole procedure. The surgeon makes small cuts rather than a large cut to do the surgery. This means that it takes less time to recover.
However, if you have an open repair operation, you are less likely to need more surgery in the future than if you have an EVAR. You are also less likely to need regular CT scans in the long term.
The type of operation you have depends on your fitness, and the size, shape and position of your aneurysm. Your surgeon talks to you about the different operations at your appointment before surgery.
Risks of open repair surgery
As with any major operation, there are risks to having surgery and a general anaesthetic (a medicine that makes you sleep during surgery). For example, there is a risk of blood loss. If that happens, you might need a blood transfusion where we give you blood from someone else (a donor).
Read more about the risks of having an anaesthetic.
There are some possible risks after having open repair surgery.
- A blood clot after surgery. We give you medicines to lower this risk. If you do get a blood clot, you will need to take tablets (warfarin) to thin your blood for 3 to 6 months.
- Chest infection after surgery. If this happens, you might need antibiotics and physiotherapy. The risk of a chest infection is higher if you smoke.
- Wound infection. This might need treatment with antibiotics. Serious infections are rare, but sometimes we need to clean the wound while you have an anaesthetic.
- Graft infection. About 1 in 500 people can get a graft infection. This is serious and you usually need treatment to remove the graft or long-term antibiotics.
- Fluid leak from wound. The wound in your groin sometimes fills with a fluid called lymph, which can leak between your stitches. This usually settles with time.
- Erection problems (impotence). This might happen in men if we cut the nerves in the tummy during the operation. About 1 in 10 people get these problems.
- Loss of circulation (blood supply) in the legs. If this happens, you might need more surgery.
These risks are rare, but it does mean that a very small number of people might not survive their operation or the time just after. Nearly 96 in every 100 patients make a full recovery.
Your surgeon talks to you about all possible risks and how they might affect you. Please ask your surgeon any questions.
Giving your permission (consent)
We want to involve you in decisions about your care and treatment. If you decide to have your procedure or treatment, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves.
If you would like more information about our consent process, please speak to a member of staff caring for you.