There are many important structures related to abdominal aorta. These include renal, iliac and visceral arteries as these can be involved in the disease process. Location of hypogastric artery is very important as loss of blood from this artery can lead to impotence in men and ischemia of sigmoid colon. During the repair, inferior vena cava and other numerous surrounding vessels can be damaged. As aorta is covered by many gastrointestinal structures like duodenum and pancreas, they can be damaged if precautions are not taken.
Before the surgery, all cardiac, renal and pulmonary functions of a patient are thoroughly evaluated. There are some general preoperative interventions which are used in all patients. These include bowel preparation with cathartic to reduce colon caliber and luminal flora (modified Condon-Nichol bowel preparation). Beta adrenergic antagonists are also administered. Prophylactic antibiotics are also given. If the patient has ventricular dysfunction, Swan-Ganz catheter is inserted and cardiac functions are optimized.
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