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Old 05-23-2012, 04:33 PM
 
Location: NJ/SC
4,286 posts, read 13,113,982 times
Reputation: 2578

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My father in law was told he has an abdominal aortic aneurysm. They want to repair it in a few weeks so I'm assuming it hasn't ruptured since it's not emergency surgery. He lives across the country so we can't go to dr appointments with him. His last visit the dr made a comment that he can have kidney failure during surgery. Does anyone know about this? Is that common?
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Old 05-23-2012, 10:06 PM
 
Location: North Carolina
102 posts, read 271,558 times
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In case you don't know what an aneurysm is, I'll explain it briefly. An aneurysm is a weakened area in the wall of a blood vessel. In the case of an AAA (abdominal aortic aneurysm), this weakening occurs in the wall of the abdominal aorta. As blood flows through the affected vessel, the pressure causes the weakened wall to bulge like a balloon. If this weakened area gets large enough, it could burst, proving fatal.

It depends on what type of repair they are doing. If the aneurysm is very large, they will have to do an open repair where they make an incision and go into the abdominal cavity. If the aneurysm isn't that large, they can do what's known as an endovascular repair. In this procedure, a small incision is made in the groin, and a catheter is inserted in the incision (it goes into the femoral artery and travels to the aorta). A stent graft is advanced into the aorta, and then opened. The graft redirects blood flow, and stops direct pressure from being applied to the aneurysm.

During an open procedure, the aorta has to be cross-clamped, and this puts a lot of strain on the heart. There is a possibility that during this surgery, the kidneys could take a hit. Kidneys really don't like any type of heart or vascular surgery, and they can be affected sometimes. Usually the kidneys regain normal function after surgery, but it can take a while.

My grandpa had a stent graft placed, and his graft somehow managed to block blood flow to some of the renal arteries. His doctor noticed that his BUN and creatinine (both measure renal function) were increasing, and ordered some scans and further testing. Sure enough, the graft was the problem. It was an easy fix, however. He had another interventional radiology procedure, the graft was removed, another was placed, and he was observed over the next few months. His renal function tests came back to normal, and the graft remained firmly in place. Everything is fine now.

Every surgery has risks, and the risk of not operating is much greater than the risk of operating. I did ER work prior to nursing school, and I've never seen someone survive a ruptured AAA. They bleed out in minutes, and there isn't anything to do for them. I think the mortality rate of a ruptured aortic aneurysm is about 90%.
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Old 05-24-2012, 12:19 AM
 
382 posts, read 619,000 times
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It's a common surgery.
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Old 05-24-2012, 06:50 AM
 
Location: NJ/SC
4,286 posts, read 13,113,982 times
Reputation: 2578
Quote:
Originally Posted by NCRNStudent View Post
In case you don't know what an aneurysm is, I'll explain it briefly. An aneurysm is a weakened area in the wall of a blood vessel. In the case of an AAA (abdominal aortic aneurysm), this weakening occurs in the wall of the abdominal aorta. As blood flows through the affected vessel, the pressure causes the weakened wall to bulge like a balloon. If this weakened area gets large enough, it could burst, proving fatal.

It depends on what type of repair they are doing. If the aneurysm is very large, they will have to do an open repair where they make an incision and go into the abdominal cavity. If the aneurysm isn't that large, they can do what's known as an endovascular repair. In this procedure, a small incision is made in the groin, and a catheter is inserted in the incision (it goes into the femoral artery and travels to the aorta). A stent graft is advanced into the aorta, and then opened. The graft redirects blood flow, and stops direct pressure from being applied to the aneurysm.

During an open procedure, the aorta has to be cross-clamped, and this puts a lot of strain on the heart. There is a possibility that during this surgery, the kidneys could take a hit. Kidneys really don't like any type of heart or vascular surgery, and they can be affected sometimes. Usually the kidneys regain normal function after surgery, but it can take a while.

My grandpa had a stent graft placed, and his graft somehow managed to block blood flow to some of the renal arteries. His doctor noticed that his BUN and creatinine (both measure renal function) were increasing, and ordered some scans and further testing. Sure enough, the graft was the problem. It was an easy fix, however. He had another interventional radiology procedure, the graft was removed, another was placed, and he was observed over the next few months. His renal function tests came back to normal, and the graft remained firmly in place. Everything is fine now.

Every surgery has risks, and the risk of not operating is much greater than the risk of operating. I did ER work prior to nursing school, and I've never seen someone survive a ruptured AAA. They bleed out in minutes, and there isn't anything to do for them. I think the mortality rate of a ruptured aortic aneurysm is about 90%.
Thank you.
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Old 05-24-2012, 01:17 PM
 
Location: Fredericksburg, Va
5,119 posts, read 12,716,950 times
Reputation: 7205
My husband had a triple A....included not only the aorta, but the artery to his left kidney and down into both legs. His was in excess of 7 cm when found...very scary! His repair was done abdominally, using a dacron replacement for the bulging aorta and other arteries...not the stent. The stent is usually reserved for those who may not tolerate a big surgery very well.....we were told hubby's surgery is 2nd to a heart/lung transplant. A serious affair, indeed!

Aside from some incisional hernias following the triple A surgery, he's fine...good recovery.
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