Could You Have An Abdominal Aortic Aneurysm?
Tick...Tick...Tick...Deep within your body there could be a time bomb silently ticking away. It's called an Abdominal Aortic Aneurysm or as referred to in the medical profession a "Triple A" or "AAA". ANY aneurysm is a time bomb in a sense. It is a bulging in a part of an artery wall that can rupture causing bleeding and/or hemorrhaging and often results in death. Abdominal Aortic Aneurysms are the most common of the aortic aneyrysms. What is an Abdominal Aortic Aneurysm? It is a bulging in the section of the aorta that extends through the abdomen.
It is a scary diagnosis at any time, but finding it and dealing with it is much better than the alternative. You often hear of young people playing sports and suddenly just dropping dead. After autopsy the diagnosis is an aneurysm somewhere in their body. The unknown aneurysm bursts or pops and it is almost always fatal.
Most people have no symptoms and never know they have one! When people are diagnosed it is usually because they have undergone tests for another reason and an aneurysm is found. In some instances if the Triple A is large enough abdominal aortic aneurysm symptoms can include pain in the back or legs, cough, bowel irregularities, pulsing in the abdomen, unexplained cough, and even chest pain.
A Triple A can be caused by many things including; family history, smoking, trauma, inflammatory disease, high blood pressure, male gender, emphysema, and high cholesterol. It is most often seen in men over 60, however, if you and your family have been lucky enough to escape this diagnosis you may never even be aware it even exists. Or, as is the case in my husband's family, if you've never heard of it until one of your brothers has one at age 63, it can be quite a learning experience, especially when you find out you have one over eight and three quarter centimeters in size!
The Aorta is the largest blood vessel in your body. It extends from the heart down into the legs and carries blood to your organs and extremities.
Abdominal Aortic Aneurysm
A Triple A can be treated conservatively if it is smaller than 5 cm. Regular monitoring and sometimes medication is all that is needed to make sure the Triple A is not getting any larger. These smaller aneurysms often stay the same size and never grow. It is the ones larger than 5 cm that are cause for concern. These aneurysms are like a balloon blown up too far and ready to pop. You never know for sure at which point they will pop so rather than wait for them to pop they need to be treated surgically and if they are large enough that means immediately. The immediate surgery will prevent the aneurysm from popping/bursting.
Team approach is used in surgery as it is a very high surgical risk. There are two types of surgery to repair the Triple A, one is called aneurysmectomy and grafting the other is endovascular stent grafting.
Aneurysmectomy is the most invasive of the two surgeries due to the opening of the chest and abdomen. In addition to being the most invasive it is the more dangerous of the two and puts you at a higher risk. You are weak after surgery, the hospital stay is at least 10 days (if all goes well) and your recovery period is lengthy.
IF you are a candidate (not everyone can have this surgery) the endovascular stent grafting is a much less invasive surgery. Two incisions are made, one on each side of the groin area. A stent is placed on the aorta extending down as far as needs be. It bypasses the aneurysm thereby eliminating it from receiving any blood flow. This procedure requires less time in the hospital and the recover period is shorter.
Left to you, I'm sure you would choose the latter, however, the decision is not yours, but your surgeon's. You also need to find a good surgeon, one with a good reputation and a good team. As mentioned earlier when I said "team approach", this surgery is performed by a team of surgeons, not just one, so knowing that your surgeon surrounds himself with good people leads to a better team for you! You can go to Pubmed.gov to see if your surgeon has published any papers on the subject. It's always a good sign to know your surgeon has published works and is keeping up on procedures.
Your age and general health are also considerations when your surgeon chooses how he will operate.
As I mentioned earlier we are now aware of the Triple A in our family. One of my brother-in-laws developed it about a year ago. His is about 3 cm and is being monitored every six months. Another of my brother-in-laws was not so lucky. He was having some back pain that increased to the point where he thought he should go to the emergency room. They immediately flew him to Albany Medical Center where surgery was performed to repair a leaking abdominal aortic aneurysm. Following these two incidents my husband decided to be screened to see if he had one.
We went to a testing center where they were performing a few tests for the general public. Stroke/Carotid Artery screening, Heart Rhythm Screen, Peripheral Artery Disease Screening, and Abdominal Aortic Aneurysm Screening. They did a sonogram and found that my husband had a 7.5 cm Triple A. They advised us to see our own physician immediately or go to the Emergency Room as this was a critical situation.
We drove to our doctor's office and explained the situation. We were taken in to see the doctor immediately, though our doctor wasn't there another doctor in the practice saw us. He was wonderful and explained we needed to see a surgeon right away. He tried contacting the surgeon but as luck would have it the surgeon's phones weren't working, seriously! So we went home and tried to call the surgeon ourselves at a later time. When we reached the surgeon he said go to the Emergency Room now. I will call ahead and have everything ready for a CAT Scan. It has been my experience that sonograms show the Triple A to be smaller than it actually is. He said he would meet us there in about an hour. True to his word, he was there when they performed the CAT Scan and he was right, the Triple A was not 7.5 cm but 8 - 3/4 cms. He explained surgery was necessary right away. However, being a weekend he couldn't get a good team together. Since he is a well-known specialist operating in several different areas he said the only times he would be in this area would be Wednesday in a nearby city or Friday in our own local hospital. We told him either would be okay as long as he was doing the surgery. As I write this we are waiting for his call to let us know which day the surgery will be. I will add a postscript noting how the surgery went in the meantime, if ANYONE in your family has a Triple A, get to a screening facility or a doctor to be checked out.
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Endovascular Stent Grafting
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