AAA repair and post op course

Nurses General Nursing

Published

How are AAA's typically repaired in pts? Is there a difference between younger pts and older? What is the typical post op recovery like?

Specializes in cardiothoracic surgery.

There are two ways to repair AAA-open or endovascular.

Endovascular--They go in through the groin and repair the aneurysm. Post op they are typically on bedrest for a few hours and then they can be OOB. If they have a foley, that comes out when they are off bedrest and the IVF are HL when they are drinking enough. You do your typical post op assessment, closely monitoring CMS checks and BP. They typically go home the next day.

Open--These patients spend the first night in the ICU and come out to stepdown the next day. They will come to us with an NG, an epidural, and Foley. Their post op course is very similar to an abdominal surgery, other than keeping a close eye on CMS checks and BP. They are probably in the hospital about 5-7 days.

Specializes in OR, Nursing Professional Development.

The endovascular repair consists of inserting a graft through the femoral artery that is then threaded through the femoral artery and aorta until it is placed properly to occlude the aneurysm and deployed. Continuous imaging is used in conjunction with IV contrast to ensure that the graft has indeed closed off the aneurysm.

Open repair involves an abdominal incision with removal of the aneurysm. The remaining pieces of aorta are then sewn to a synthetic graft.

The determination of endovascular vs open repair is based on patient's condition, ability to tolerate anesthesia (open repairs are done under general, endovascular can be done under spinal), and location of the aneurysm (if too close to the renal arteries, open is the only option). Leaking aneurysms can be repaired either way, but ruptured can only be repaired open.

Not sure about the post op course, since I actually work in the OR, but I know that all of our open repairs go to ICU.

Twenty years ago when I worked in ICU, a post AAA would come to the unit, be on pavulon x24 hrs, vented,

A-line,the whole nine yards. Most would be in the unit at least 48 hrs.

It's homework time?

It's homework time?

HA HA! No...as you can see from my previous post (should you have read them before choosing to jump to the conclusion that I was doing homework) I am a nurse in home health. I am currently seeing a pt that was recently admitted to the hospital for a AAA repair that was found by coincidence while being examined for another issue. I was curious as to what a AAA repair entailed and what the post operative course was like. I asked about if there was a difference in procedure depending on age because I had read that a AAA can be repaired 2 ways. My pt is 31 and relatively healthy. I'm sure it sounded like a homework question, but I have posted several times on this board about my job and was genuinely curious about what my pt was going through.

HA HA! No...as you can see from my previous post (should you have read them before choosing to jump to the conclusion that I was doing homework) I am a nurse in home health. I am currently seeing a pt that was recently admitted to the hospital for a AAA repair that was found by coincidence while being examined for another issue. I was curious as to what a AAA repair entailed and what the post operative course was like. I asked about if there was a difference in procedure depending on age because I had read that a AAA can be repaired 2 ways. My pt is 31 and relatively healthy. I'm sure it sounded like a homework question, but I have posted several times on this board about my job and was genuinely curious about what my pt was going through.

Well, Google is my friend.

Well, Google is my friend.

Are you suggesting that I should have googled my question rather than ask it here? 1. The internet is not the most reliable source of info. 2. I did Google it; found out there were two different surgical approaches and then came here to ask which one was seen most commonly. 3. I thought that's what this board was for? Nurse to share info about their experiences. Sheesh!!! I didn't expect for you to be so cynical and attack me for asking a question and being concerned about my pt....

This is the story of nursing always trying to act like their better or smarter than their colleagues. (I probably spelt it wrong and I don't care). I just this minutes joined this site. And here I see the same garbage I've seen through my whole 31 years. We should have become the strongest union in the world. We as nurses ran everything. But self destruction from within always keeps us down. I loved my patients but I hated dealing with the nurses who were so insecure they tore each other down. You all have my name if you would like to direct any comments to me. I'd love it

I am talking about the smart ass who told the nurse to google it

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