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AAA and other operations
Nov 14, 2010

I am 63, dxed 2+yrs ago, undetectable viral load and 550 CD4. I have a AAA that is 3.7 cm (about 1 cm growth in last year). I know the standard is to wait until it is 5 cms. However, I feel myself more fatigued each passing month and I worry that by the time it reaches 5 cm, I will not be healthy enough to withstand an operation. In my case, does waiting still outweigh the dangers of surgery?

Also, I am scheduled for a ureathroplasty in January. It is a complicated reconstruction and I will be under general anesthesia for 3-4 hours. What precautions can/should I take. The urologist kind of just passed over my HIV status and said get a release from your primary care physician and I will be good to go. I am a veteran being treated by the VA and I have heard many horror stories. Heck, they even transmitted HIV to some folks because of improper procedures. So, any insights you can provide would be greatly appreciated.

Thank you.

Response from Dr. Frascino

Hello,

As I am neither a cardiovascular/thoracic surgeon or urologist, I am completely unqualified to answer your questions. From an HIV perspective, if your CD4 counts remain good (yours are quite good) and your HIV plasma viral load remains suppressed to undetectable levels, there should be no significant HIV-related complications related to having surgery. Surgical healing time should be the same as non-HIVers. Certainly your HIV specialist should be involved in monitoring your condition and recovery for both procedures. For instance, there may be some juggling of medications due to restrictions on oral intake immediately before and after surgical procedures. If you don't have an HIV specialist physician now, you definitely should establish care with one prior to undergoing the surgeries.

Good luck.

Dr. Bob


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