I don't feel it at ordinary times, but it is fatal when it is broken.

An aortic aneurysm is an abnormal enlargement of the aorta. When the diameter of the enlarged part exceeds 1.5 times the dia

I don't feel it at ordinary times, but it is fatal when it is broken.

An aortic aneurysm is an abnormal enlargement of the aorta. When the diameter of the enlarged part exceeds 1.5 times the diameter of the normal aorta, it is called an aortic aneurysm. Dr. Wu, from the Department of Cardiovascular Surgery, Affiliated Hospital of Medical College of National Taiwan Province University, pointed out that aortic aneurysm is like a balloon, the bigger it is, the easier it is to rupture. Once the aortic aneurysm ruptures, it will lead to massive hemorrhage, which is an extremely dangerous emergency.

According to statistics, when abdominal aortic aneurysm ruptures, only about half of patients can get to the hospital when there are signs of life. After arriving at the hospital, about half of the patients could not survive the operation and died!

Aortic aneurysms are so deadly, but there are often no obvious signs. Dr. Wu said that the aorta is located in the depths of the human body and can't be touched or seen. Before the aortic aneurysm ruptured, most patients in the hospital did not feel abnormal. Only a few patients have symptoms, usually because the aortic aneurysm is too large to press the nearby organs, such as thoracic aortic aneurysm to press the recurrent laryngeal nerve, which affects the function of vocal cords and leads to hoarseness, but most people usually don't associate hoarseness with aortic aneurysm, so it is very easy to ignore its seriousness.

According to Dr. Wu's analysis, aortic aneurysms can be divided into spindle and saccular according to their types.

Spindle aortic aneurysm, with symmetrical enlargement, is a common degenerative aortic aneurysm; Balloon aortic aneurysm is a so-called "atypical aortic aneurysm", which is caused by infection, trauma or pseudoaneurysm at the junction of surgery.

Dr. Wu Yihui explained: "We will decide the treatment plan according to the risk of abdominal aortic aneurysm rupture. For example, the diameter of spindle abdominal aortic aneurysm is less than 5 to 5.5 cm, and the risk of rupture is relatively low, and most of them will be treated with drugs first; Balloon aortic aneurysm has a high risk of rupture, even if it is small, interventional therapy will be considered. 」

In the choice of drugs, antihypertensive drugs, especially "B-type sympathetic nerve blockers" are used in principle, hoping to reduce the number of heartbeats, blood pressure and cardiac contraction tension. If you still can't lower your blood pressure enough, you need to use other antihypertensive drugs as an aid.

Active treatment to prevent aortic aneurysm rupture If the risk of aortic aneurysm rupture is high, surgical treatment will be recommended. Traditional open surgery patients need general anesthesia. The doctor opened the patient's abdominal cavity, removed the abdominal aortic aneurysm, and then sutured the artificial blood vessel. Dr. Wu said, "Endovascular stent implantation is a minimally invasive, relatively safe and long-term effective treatment method that has become more and more popular in recent 15 and 20 years. 」

Dr. Wu explained that the operation of aortic stent implantation is to send the aortic stent from both groins to the abdominal aorta through the femoral artery, and then release the aortic stent completely after X-ray location. In this way, the blood will flow in the aortic stent and will no longer impact the aortic aneurysm. After the operation, the patient had only a small wound in the groin. Compared with traditional open surgery, it has less trauma, less bleeding and shorter operation time.

Because the wound is very small, patients can operate under local anesthesia or semi-anesthesia, with less postoperative pain and faster recovery. Dr. Wu Yihui said: "After the aortic stent is released, patients can get out of bed and eat food earlier, even after 2 or 3 days, as long as the situation permits, they can resume normal daily activities. From the multi-center clinical research, it is found that the mortality rate after 30 days of aortic stent implantation is one third less than that of traditional open surgery, which is the mainstream way to treat abdominal aortic aneurysm at present. 」

Preoperative planning is the key to successful operation. Dr. Wu said that the placement of aortic stent is fixed by the tension of stent and the friction between aortic walls. However, due to the aging of the vascular wall, stent displacement and blood leakage from the gap of stent sometimes occur, so long-term follow-up is needed after operation to determine the stability of aortic stent. For young patients, it is generally recommended to perform traditional open surgery and do more accurate suture; As for older patients, because they are usually accompanied by other cardiovascular diseases, they may not be able to withstand open surgery with relatively large wounds, so it is a reasonable choice to use aortic stent implantation.

In the past, some patients were limited by congenital conditions, and only 40% of them met the anatomical conditions and could accept aortic stent implantation. However, with the progress of science and technology and the development of more diversified medical equipment, about 70~80% of patients now have corresponding treatment measures. Dr. Wu said: "From preoperative planning, relying on the professional experience and cooperation of the medical team during the operation, plus good postoperative care and long-term follow-up, we can ensure the long-term curative effect of patients and effectively reduce the incidence of complications. 」

Dr. Wu shared: "There was a patient who suffered from ruptured aortic aneurysm at the age of 89 and underwent aortic stent implantation. He recovered smoothly after surgery and lived to be in his 90 s.. There are also patients in their 70 s who have surgery. They have been followed up for 13 years and 14 years and can still play golf. There are also quite young patients with systemic aneurysms due to connective tissue diseases. We performed repair and stenting step by step from ascending aorta, aortic arch, descending aorta to abdominal aorta. These are the achievements made by the progress of modern medical technology, which is obvious to all. 」

Do I need to be screened for abdominal aortic aneurysm? Dr. Wu reminded that if there is a history of aortic aneurysm, it is not recommended to lift weights, because lifting weights may increase the blood pressure from 120 mmHg to 180 mmHg in a short time, and the blood pressure suddenly fluctuates in just a few seconds, which is easy to impact the aortic aneurysm and cause rupture.

In the long run, blood pressure control is very important. Our heart beats about 70 times a minute, and it beats more than 65438+ million times a day. That is to say, aortic aneurysm will beat more than 65438+ 10,000 times a day because of heart beating, and the risk of blood pressure 120 mmHg and 160 mmHg is very different.

Risk factors of abdominal aortic aneurysm include age over 60, male, smoking and family history. Dr. Wu reminded: According to the recommendation of the American Society of Vascular Surgery, men and women over 65 years old with smoking history or family history are advised to have at least one abdominal ultrasound screening for abdominal aortic aneurysm, so as to find and treat it early and avoid aortic aneurysm rupture! Take control of your health!