Name of the Procedure:

Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis

Summary

This is a surgical procedure to repair an aneurysm or dissection in the infrarenal (below the kidneys) section of the aorta. It involves using a tube-shaped prosthesis to strengthen the artery after an endovascular repair attempt has failed.

Purpose

This procedure addresses damaged or weakened sections of the aorta below the kidneys, which can lead to life-threatening bleeding or rupture. The goal is to restore normal blood flow and prevent further complications.

Indications

• Presence of an infrarenal aortic aneurysm or dissection
• Previous unsuccessful endovascular repair
• Symptoms such as severe abdominal or back pain
• Evidence of arterial trauma or other complications

Preparation

• Fasting for at least 8 hours before the surgery
• Adjustment or discontinuation of certain medications, as advised by the doctor
• Pre-operative diagnostic tests including blood tests, imaging studies like CT scans, and cardiovascular assessments

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the abdomen to access the aorta.
3. The aneurysm or dissection site is located.
4. The damaged portion of the aorta is removed or repaired.
5. A tube-shaped prosthesis is sewn in place to reconstruct the vessel.
6. Repair of any associated arterial trauma is carried out.
7. The incision is closed and sterile dressings are applied.

Specialized surgical tools and vascular grafts are utilized throughout the procedure.

Duration

The procedure typically takes 3 to 6 hours, depending on complexity.

Setting

Performed in the operating room of a hospital.

Personnel

• Cardiovascular surgeons
• Anesthesiologists
• Surgical nurses
• Surgical technologists

Risks and Complications

• Bleeding or infection
• Injury to surrounding organs or tissues
• Blood clots
• Heart attack or stroke
• Kidney failure
• Leakage or failure of the graft
• Possible need for additional surgery

Benefits

• Restoration of normal blood flow
• Elimination of symptoms
• Prevention of aneurysm rupture or further dissection
• Improved overall survival and quality of life post-repair

Recovery

• Hospital stay of 5 to 10 days
• Pain management with medications
• Gradual return to normal activities over 4 to 6 weeks
• Follow-up appointments for monitoring and imaging tests
• Restrictions may include avoiding strenuous activities and heavy lifting

Alternatives

• Continued endovascular repair attempts
• Minimally invasive surgeries if they are feasible
• Medical management with close surveillance (less effective for large aneurysms or dissections)

Patient Experience

During the procedure, the patient will be under general anesthesia and won’t feel pain. Post-surgery, they might experience discomfort and need pain management. Recovery includes hospital stay for monitoring and activities will be limited initially to ensure proper healing.