saccular dilation does not involve the whole aorta involves its own little sac

Saccular dilation does not involve the whole aorta

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saccular dilation does not involve the whole aorta; involves its own little sac Causes of true aneurysms: - the exact cause of true aneurysms are unknown. - It may be atherosclerosis (plague) of the intima diabetics at most risk - Degenerative changes to the media - This leads to weakening and eventual dilation of aorta 2. A false aneurysm is not an aneurysm, but a disruption of all layers of the arterial wall resulting in bleeding that is contained by surrounding structures. c. Clinical manifestations of Aneurysms - Depends on location of aneurysm. - Can be asymptomatic—thoracic aneurysm (above renal arteries) - Can have deep, diffuse chest pain. - Can produce hoarseness, dysphagia, back pain (abdominal aneurysm) d. Complications of Aneurysms : untreated can result in rupture. e. Diagnostic studies for Aneurysms : Chest x-ray, angiography (good picture of aorta), MRI, CT scan f. Collaborative Care for Aneurysms a. Goal : to prevent rupture. Early detection is key i. Conservative treatment of 4 cm or less aneurysm 1. diet 2. watch BP ii. Surgical treatment if aneurysm is 5- 6 cm 1. synthetic graft (Dacron) a. clamp above and below b. patient is on by pass machine c. cut out aneurysm (blood goes everywhere) d. sewn in graft, release clamps, and voila!! Post Op Synthetic Graft Treatment: - blood pressure hypotension and hypertension should be avoided 2
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- CV status - monitor for infection (temp, redness, warmth, purulent drainage, CBC) - GI status unusual for paralytic ileus to persist beyond 4 th post op day - assess bowel sounds - watch graft patency - incentive spirometer - splinting with pillow if coughing to hold sutures together - encourage deep breathing and coughing (atelectasis can occur if they don’t breathe deeply) - stool softener to prevent straining after surgery - activity tolerance, may need oxygen - signs and symptoms of bleeding (BP) Post Op Graft Interventions - watch for infection (WBC count) - Monitor Input and Output - usually NPO after procedure Minimally invasive procedure: - must meet criteria- don’t use if affects renal arteries - can leak - graft dysfunction grafts don’t work really well Aortic Dissection - tear in intima of the artery-> blood goes between intima and media (creates its own little lumen) creating a false lumen of blood flow - each systolic pulsation causes increased pressure to the damaged area - occludes major branches of aorta and cuts off blood supply to organs - develops over time - cause of dissection is unknown - symptoms of aortic dissection: sudden, severe pain; can mimic MI pain - if blood goes into pericardial sac (lining around heart), it can cause cardiac tamponade (squeezes heart; heart can’t pump), which can lead to asystole - most common occurs in the thorax Aortitis - rare and involves inflammation of the aorta - almost always secondary to another disease process (i.e.,, syphilis) - treat with NSAIDS, corticosteroids - patient will have fever, pain Aortoiliac disease - narrowing of iliac arteries - decreases blood flow to lower extremities - occurs at bifurcations - common in diabetics - primary symptom: intermittent claudication (pain below level where occlusion is) Causes and risk factors of Aortoiliac disease o atherosclerosis 3
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  • Spring '08
  • Dupuy
  • Venous insufficiency, chronic venous insufficiency, lower extremities

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