TAA+AAA surgical

Question 1

What should be optimized before aneurysm surgery?

Answer 1

Hydration, electrolytes, coagulation, and hematocrit.

Question 2

How long does an aneurysm surgical repair typically take?

Answer 2

About 30–45 minutes.

Question 3

What is cross-clamping?

Answer 3

Temporary placement of a clamp on a blood vessel to control or stop blood flow during surgery.

Question 4

What is done during an open aneurysm repair?

Answer 4

1️⃣ Cut into diseased aortic segment 2️⃣ Remove thrombus/plaque 3️⃣ Suture synthetic graft proximal/distal to aneurysm 4️⃣ Wrap native aortic wall around graft for protection.

Question 5

What is the goal of open aneurysm repair?

Answer 5

Reinforce the aneurysm from the inside.

Question 6

What major post-op complication can occur if aneurysm is above the renal arteries?

Answer 6

Acute Kidney Injury (AKI) from decreased renal perfusion due to cross-clamping.

Question 7

What is an endovascular graft procedure (EVAR)?

Answer 7

Minimally invasive placement of a sutureless aortic graft via femoral artery—no cross-clamping required.

Question 8

What is the goal of EVAR?

Answer 8

Reinforce the aneurysm from the outside and prevent further expansion.

Question 9

What vessels are used for EVAR?

Answer 9

Femoral arteries.

Question 10

How is the endovascular graft deployed?

Answer 10

Balloon inflation positions graft against the vessel wall, allowing blood to flow through the graft.

Question 11

What imaging is done after EVAR?

Answer 11

Angiography—checks for leaks and patency of graft.

Question 12

What are eligibility requirements for EVAR?

Answer 12

1️⃣ Iliofemoral vessels allow safe graft insertion 2️⃣ Adequate vessel length and width to support graft.

Question 13

What is an endoleak?

Answer 13

Seepage of blood into old aneurysm sac due to inadequate seal, fabric tear, or leak between segments.

Question 14

How is an endoleak treated?

Answer 14

Embolization or additional repair.

Question 15

What other complications can occur after graft repair?

Answer 15

Aneurysm growth, rupture, aortic dissection, renal artery occlusion, bleeding, hematoma, infection.

Question 16

Why is ongoing imaging needed after graft repair?

Answer 16

To monitor aneurysm and graft stability and detect leaks or expansion.

Question 17

What is intraabdominal hypertension (IAH)?

Answer 17

Increased intraabdominal pressure impairing organ perfusion.

Question 18

What is abdominal compartment syndrome (ACS)?

Answer 18

Severe IAH causing multisystem organ failure due to impaired perfusion.

Question 19

What are treatments for IAH/ACS?

Answer 19

Open decompression, percutaneous drainage, intubation/ventilation, gastric decompression, pain management, cautious fluid resuscitation, temporary hemofiltration.

Question 20

What are the three main goals for patients undergoing aortic surgery?

Answer 20

1️⃣ Normal tissue perfusion 2️⃣ Intact motor/sensory function 3️⃣ No surgical complications (thrombosis, infection, rupture, endoleak).

Question 21

What are health promotion strategies for aneurysm patients?

Answer 21

BP control, smoking cessation, healthy weight, normal lipid levels, CVD risk reduction.

Question 22

How long are patients typically monitored in the ICU post-op?

Answer 22

24–48 hours.

Question 23

What lines/tubes are used post-op for monitoring?

Answer 23

Arterial line (BP), NG tube, ECG, pulse oximetry.

Question 24

Why is an arterial line used post-op?

Answer 24

To continuously monitor BP for hypovolemia or sepsis.

Question 25

What is the purpose of the NG tube post-op?

Answer 25

To decompress stomach, prevent aspiration, and reduce pressure on surgical site.

Question 26

What is important for pain management after aneurysm surgery?

Answer 26

Use of PCA or epidural for comfort and to reduce stress response.

Question 27

What must nurses continuously monitor post-op?

Answer 27

Graft patency and renal perfusion.

Question 28

What indicates poor renal perfusion post-op?

Answer 28

Decreased urine output, elevated BUN/creatinine.

Question 29

What indicates compromised graft patency?

Answer 29

Absent pulses, cool extremities, or sudden drop in BP.

Question 30

What are early warning signs of post-op complications?

Answer 30

Decreased urine output, tachycardia, hypotension, neurologic changes, pain, bleeding.