provided by Austin Heart

Overview
Definition

An aneurysm is the "ballooning" of an artery caused by the weakening of the arterial wall. Apart from occasional low back pain, an aneurysm in the abdominal aorta usually causes no symptoms. However, large aneurysms can burst without warning, causing internal bleeding and usually ending in death. Fortunately, aneurysms can be treated surgically before rupture occurs.
 

DIAGNOSIS OF AN ANEURYSM
Your doctor may first suspect that you have an aneurysm while conducting a routine physical examination or while you are hospitalized for another problem. To confirm the diagnosis, a complete physical exam and special tests are necessary.


History and Physical Exam
Your doctor will ask whether you have low back pain or tenderness below the ribs. These symptoms are sometimes suggestive of an abdominal aneurysm. As part of an examination, your doctor will carefully feel your abdomen for signs of swelling or tenderness. X­rays may be ordered to rule out other causes of your symptoms.


Ultrasound
Images of an aortic aneurysm can be obtained quickly and painlessly with ultrasound (or sonography). High­frequency sound waves are sent through the skin and the echoes form an image on a TV monitor. Most medium­to­large aneurysms can be seen. All you will feel is the technician sliding the probe over your stomach.


CT Scan
Your tests may include a CT scan (computerized tomography). CT is like an x­ray, except that the images appear as a series of thin slices. When viewed together they provide a three­dimensional image. To make selected areas easier to see, you may be given a special dye to drink or by injection. You will not feel the scanner.


Arteriography
Arteriography is occasionally used to take more detailed pictures of an aneurysm. A special x­ray visible dye is injected into the aorta above the area of the aneurysm. As dye is released, x­rays are taken, revealing both the size and location of the aneurysm. You may feel a slight burning sensation as the dye is released into the circulation.


SURGERY FOR AN ANEURYSM
A large aneurysm in the abdomen is particularly dangerous, since it can burst at any time. The majority of large aneurysms rupture within one or two years. Surgery is necessary to correct the problem before rupture occurs.


Surgery
Surgery to correct an aneurysm usually takes from two to three hours. During this time you will be under general anesthesia and won't feel anything. First, the surgeon locates and exposes the aneurysm. With the aorta clamped to prevent bleeding, the aneurysm is then opened. Next, a synthetic, Y­shaped graft is stitched to the aorta at one end and the two iliac arteries at the other. The graft carries blood to the legs.


After Surgery
After surgery you may be in the ICU for 24­48 hours to enable close monitoring of your breathing and heart function. Initially, all fluids will be given through an intravenous (I.V.) line placed into a vein. As you recover, you will be encouraged to get out of bed and walk about. Your doctor will let you know when you can leave the hospital and resume your normal activities.