I was just diagnosed with a 4 cm abdominal aortic
aneurysm, and I am otherwise healthy. Shouldn't I repair the aneurysm now,
before it expands? I may not be a good surgical candidate later.
The decision you and your doctor make will be based on your
condition, the risk of death or injury the
aortic aneurysm poses, and the risks of surgery. The
operation is not without risks, with a significant chance of injury or death,
and many doctors prefer to avoid these risks unless the operation will result
in a definite survival benefit.
Overall, experts feel that the chance of a rupture of a 4 cm aneurysm
is low and that it is in your best interest to monitor the aneurysm and repair
it if it gets larger.
How long will I be in the hospital after my
operation?
If you are healthy and have a smooth operative and postoperative
course, you can expect to be in intensive care (ICU) for 24 hours and in the
hospital for 5 to 10 days. If there are complications, you may have to stay
longer in the hospital.
After you have returned home, it may take as long as 6 months to
fully recover from surgery for an abdominal aortic aneurysm. You should follow
up with your surgeon about a week after leaving the hospital and at this
meeting determine future meetings and when you can return to work, drive, and
resume other activities.
While at home, you will at first feel tired and weak. You will
probably need assistance in many daily activities, and you may benefit from
short-term placement in a rehabilitation center. You should do no heavy
lifting, as this may lead to
hernia, but you should begin walking 2 to 3 days after
returning home. You will likely need pain medicine.
Most people who have abdominal aortic aneurysm surgery recover
well.
Will I have erection problems after the
operation?
Erectile dysfunction, caused by injury to the nerves
located next to the abdominal aorta, occasionally occurs. Sometimes men have
erectile dysfunction (impotence) temporarily after surgery, but function is
later regained. But for others, erectile dysfunction is permanent.
I have cancer. Should I have surgery for an
abdominal aortic aneurysm?
This is a question for you and your doctor to decide. Together, you
can weigh the risk of rupture against how long you are expected to live.
Surgery may make sense if you are expected to live longer than 2 years.
I have kidney disease. How will this affect my
outcome?
Those with kidney disease have a higher risk for complications during
surgery for abdominal aortic aneurysm. If you are on dialysis, your situation
needs to be looked at carefully, and you may need special monitoring at the
time of surgery. If you have chronic renal failure but are not on dialysis, you
need to be monitored very closely in the days surrounding the operation, as
there is the chance you will suffer some kidney damage during the operation and
may require dialysis in the postoperative period. You may also
be at increased risk for postoperative bleeding. But the surgery should
still be considered if the aneurysm meets operative criteria.