Thoracic aortic aneurysm surgery: Overview
Aortic aneurysm repair is surgery to fix a weak and bulging section of the aorta. The aorta is the large blood vessel (artery) that carries blood from the heart through the chest and belly to the rest of the body.
To repair the aneurysm, a doctor uses a man-made tube (called a graft) to replace the weak and bulging section of the aorta in your chest. The doctor will make a large cut in your chest. The doctor may connect you to a machine that does the jobs of your heart and lungs. It's called a heart-lung bypass machine. General anesthesia is used for this surgery.
You may spend several days in the hospital. You will need to take it easy for at least 4 to 6 weeks at home.
How is thoracic aortic aneurysm surgery done?
The doctor will make a large cut (incision) in your chest. The cut may be made through the breastbone (sternum). Or it may be in the side of your chest between your ribs.
General anesthesia is used for this surgery. During the surgery, the doctor may connect you to a machine that does the jobs of your heart and lungs. It’s called a heart-lung bypass machine. This machine isn't always used.
The doctor will put clamps on the aorta above and below the aneurysm. This stops blood flow through the area that the doctor is working on. The doctor will replace the weak section of your aorta with a man-made tube (called a graft).
After the aorta is fixed, the doctor will remove the clamps. Blood can then flow through the aorta again. Then the doctor will use stitches or surgical staples to close the incision in your chest.
After thoracic aortic aneurysm repair surgery: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have severe trouble breathing.
- You have sudden chest pain and shortness of breath, or you cough up blood.
- You have chest pain or pressure. This may occur with:
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms.
- Dizziness or lightheadedness.
- A fast or uneven pulse.
Call your doctor now or seek immediate medical care if:
- You have new or increased shortness of breath.
- You are short of breath and cough up foamy, pink mucus.
- You are dizzy or lightheaded, or you feel like you may faint.
- You are sick to your stomach or cannot keep fluids down.
- You have pain that does not get better after you take pain medicine.
- You have a fever over 100°F.
- You have loose stitches, or your incision comes open.
- Bright red blood has soaked through the bandage over your incision.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- Swollen lymph nodes in your neck, armpits, or groin.
- A fever.
- You have sudden weight gain, such as 3 pounds or more in 2 to 3 days.
- You have signs of a blood clot, such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
Watch closely for any changes in your health, and be sure to contact your doctor if:
- You have increased swelling in your legs, ankles, or feet.
How do you prepare for thoracic aortic aneurysm surgery?
Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.
Preparing for surgery
- Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
- Understand exactly what surgery is planned, along with the risks, benefits, and other options.
- Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
- If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
- Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.
How can you care for yourself after thoracic aortic aneurysm surgery?
Activity
- Rest when you feel tired. Getting enough sleep will help you recover.
- Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
- Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for up to 3 months.
- For 6 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
- Hold a pillow over your incision when you cough or take deep breaths. This will support your chest and decrease your pain.
- Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
- Ask your doctor when you can drive again.
- You will probably need to take at least 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.
- You may shower as usual. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
- Ask your doctor when it is okay for you to have sex.
Diet
- You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
- You may not feel as hungry as usual, or food may not taste as good as it usually does. This is common and usually gets better about 4 weeks after surgery. If you do not feel like eating, you may want to drink liquid meal replacements for extra calories and protein. This can help you keep up your strength and prevent weight loss.
- Drink plenty of fluids (unless your doctor tells you not to).
- You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
Medicines
- Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
- If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
- Be safe with medicines. Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
- If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
- If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
Incision care
- If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
- Wash the area daily with warm, soapy water, and pat it dry. Other cleaning products, such as hydrogen peroxide, can make the wound heal more slowly. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
- Keep the area clean and dry.
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