Thoracic Aortic Aneurysm Repair Surgery: Before Your Surgery

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What is thoracic aortic aneurysm repair?

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. An aortic aneurysm that is not repaired may burst (rupture). This can be life-threatening. Your doctor will use a man-made tube (called a graft) to replace the weak section of your aorta in your chest.

The doctor will make a large cut (incision) in your chest. The incision may be made through the breastbone (sternum), or the incision may be in the side of your chest between your ribs. During the surgery, the doctor may connect you to a machine that does the jobs of your heart and lungs (heart-lung bypass machine). This machine will allow the doctor to stop your heartbeat while he or she works on your aorta. 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 graft. In some cases, the doctor can do surgery without using a heart-lung bypass machine.

After the aorta is repaired, the doctor will remove the clamps so blood can flow through the aorta again. Then the doctor will use stitches or surgical staples to close the incision in your chest.

You will probably spend 5 to 7 days in the hospital. You will need to take it easy for at least 4 to 6 weeks at home.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Having surgery can be stressful. This information will help you understand what you can expect and how to safely prepare for surgery.

Preparing for surgery

  • Bring a list of questions to ask your doctors. It is important that you understand exactly what surgery is planned, the risks, benefits, and other options before your surgery.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines to take or stop before your surgery.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • You may need to stop taking certain medicines a week or more before surgery, so talk to your doctor as soon as you can.
  • Before your surgery, you will speak with an anesthesia provider to discuss your anesthetic options, including the risks, benefits, and alternatives to each. This may be on the phone or in person.

Taking care of yourself before surgery

  • Build healthy habits into your life. Changes are best made several weeks before surgery, since your body may react to sudden changes in your habits.
    • Stay as active as you can.
    • Eat a healthy diet.
    • Cut back or quit alcohol and tobacco.
  • If you have an advance care plan, let your doctor know. If you do not have one, you may want to prepare one so your doctor and loved ones know your health care wishes. Doctors recommend that everyone prepare these papers before surgery, regardless of the type of surgery or condition.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking, or your surgery may be cancelled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do NOT shave the surgical site yourself.
  • Remove all jewellery, piercings, and contact lenses.
  • Leave your valuables at home.

At the hospital or surgery centre

  • Bring a picture ID.
  • Before surgery you will be asked to repeat your full name, what surgery you are having, and what part of your body is being operated on. The area for surgery may be marked.
  • A small tube (IV) will be placed in a vein, to give you fluids and medicine to help you relax. Because of the combination of medicines given to keep you comfortable, you may not remember much about the operating room.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 2 to 6 hours.
  • You will probably go to the intensive care unit (ICU) after surgery. You will probably stay in the ICU for 1 or 2 days before you go to your regular hospital room.
  • You will have a breathing tube down your throat. This is usually removed within 6 hours after surgery.
  • You may have a thin plastic tube in your nose that goes down the back of your throat into your stomach to drain stomach juices. It is usually removed when the breathing tube is removed.
  • You may have one or more tubes coming out of your chest to drain fluid that can build up after surgery. The chest tubes are usually removed within 2 days after surgery.
  • As you wake up in the ICU, the nurse will check to be sure you are stable and comfortable. It is important for you to tell your doctor and nurse how you feel and ask questions about any concerns you may have.

Going home

  • Be sure you have someone to drive you home.
  • For your safety, you should not drive until you are no longer taking pain medicines and you can move and react easily.
  • Arrange for extra help at home after surgery, especially if you live alone or provide care for another person.
  • You will be given more specific instructions about recovering from your surgery, including activity and when you may return to work.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to http://www.healthwise.net/ed

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