Post-Operative Care After Open Repair of Abdominal Aortic Aneurysm

Surveillance Imaging Protocol

The European Society of Cardiology recommends first follow-up imaging within 1 post-operative year using CT or MRI, and repeat imaging every 5 years thereafter if findings remain stable, to detect para-anastomotic aneurysms and aneurysms in noncontiguous arterial segments 1, 2, 6
The American Heart Association suggests that para-anastomotic aneurysms occur in 1% at 5 years, 6% at 10 years, and 27-35% at 15 years post-operatively, and late aortic aneurysms in noncontiguous arterial segments occur in 45% of patients at mean 7 years post-operatively 7

The European Society of Cardiology recommends implementing optimal cardiovascular risk management to reduce major adverse cardiovascular events, which pose greater mortality risk than aneurysm rupture itself 2
The American College of Cardiology suggests that routine coronary angiography and systematic revascularization before AAA repair is NOT recommended in patients with chronic coronary syndromes 1, 2, 3

The European Society of Cardiology recommends invasive monitoring with arterial line and continuous three-lead ECG recording for high-risk patients requiring ICU care 3, 4
The World Journal of Emergency Surgery suggests that carefully scrutinizing fluid balance throughout the post-operative period is crucial, and tailoring inotropes and vasopressors according to patient condition and performed surgical interventions 5

The World Journal of Emergency Surgery recommends immediate and adequate nutritional support, as open abdominal surgery creates a hyper-metabolic condition, and starting early enteral nutrition as soon as possible in the presence of viable and functional gastrointestinal tract 5