Follow-up after triple AAA-surgery

I’m not a doctor, but I did survive a catastrophic Type A aortic dissection in 2015 that required emergency open-heart surgery and a Dacron graft repair. That experience forever changed the way I think about the aorta—and what it means to be alive afterward. Based on your story, it sounds like you underwent major open repair of an abdominal aortic aneurysm (AAA) with a bifurcated "pant-graft" or "trouser graft"—a term often used to describe a graft that extends into both iliac arteries. The size of your largest aneurysm—10 cm—is dangerously large. It’s a miracle you survived. Truly. To your question: Yes, it is absolutely possible for new aneurysms to form even after surgical repair. Here’s why ongoing surveillance is important:

1. Remaining native aorta: While the repaired portion of the aorta is protected by the graft, other segments—upstream (thoracic) or downstream (iliac or femoral)—remain at risk of developing aneurysmal disease.
2. Degenerative nature of the disease: Aneurysms often result from underlying connective tissue degeneration (sometimes genetic, sometimes age-related), so if one section was affected, others may eventually be too.
3. Anastomotic pseudoaneurysms: At the sites where the graft was sewn into the native aorta, pseudoaneurysms can sometimes develop over time.
4. Graft-related complications: While rare, grafts can develop issues such as migration, endoleaks (in endovascular repairs), or structural fatigue.

Given all that, lifelong surveillance is strongly recommended. The typical protocol includes annual imaging (CT angiography or duplex ultrasound), or more frequently if anything suspicious is found. I get a chin to knees CT scan with contrast EVERY year. Also, regular follow-up with a vascular surgeon or cardiologist familiar with aortic repair cases. Blood pressure control is essential. Aneurysms thrive under pressure.

You didn’t mention whether your aneurysms were inflammatory, mycotic, genetically linked (like Marfan or Loeys-Dietz), or degenerative, but any of those scenarios would further support the need for continued follow-up. Your survival is remarkable. Knowing what you know now, the smartest thing you can do is stay ahead of it. Peace.

You had three, I’m not a Dr but that sounds like propensity. I had 2 one in my brain one ascending aortic, both repaired. But there have been other cases in my family, so my cardiologist who is an aneurysm expert orders full aortic scans every 4-5 years to ensure no other aneurysms are appearing, he is also a geneticist so he believes my family may have an unknown marker (I don’t show any of the known ones). He also adds the brain if my neurosurgeon has not seen me in a while (I get follow ups every 2 years with the NS). That’s. 3 + hr inside an MRI machine, checking groin, abdomen, thorax and if required brain. I just had my second one done a month ago (previous was 4 years ago, 1 year after my aortic repair). This is in addition to my annual echocardiogram to check my aortic valve and the graft in my aorta. He says there is a chance, although maybe small that I may develop a dilation where the graft was sawn to the aorta. So continual follow up is necessary

I'm not a doctor, but I'd say, Yeah, get those checkups.