[Progress in the surgery of abdominal aortic aneurysm].
Between 1960 and 1989, 609 patients were operated on for abdominal aortic aneurysms. They were 38 females and 571 males from 45 to 87 years old (mean 69). The series has been divided into three consecutive periods: From 1960 to 1973, 135 patients (30 ruptures); from 1974 to 1981, 176 patients (55 ruptures) and from 1982 to 1989, 298 patients (49 ruptures). Perioperative mortality for elective surgery was 8.5% during the first period and 3.2% during the last one. For ruptured aneurysms mortality decreased from 66% to 34%. In the same way, the incidence of rupture decreased from 31.2% to 16.4%. Progresses making possible improvements of the results are related to an early detection with ultrasounds and CT scan, a more precise evaluation of associated pathologies, simplification of surgical techniques, evolution of anesthesia and supportive measures (monitoring, autologous transfusion). On the other hand, rupture is still lethal due to delay in diagnosis and surgery, site of the rupture and multiorgans consequences of hemorrhagic shock. It is only by an echographic screening of people at risk (age, cardiovascular diseases) that frequency can be reduced.
Thevenet
A
A
Service de Chirurgie Thoracique et Cardio-vasculaire, Hôpital Aiguelongue, Montpellier.
François
F
F
Albat
B
B
D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D001012:Aorta, Abdominal; D001014:Aortic Aneurysm / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D012151:Resuscitation; D013997:Time Factors
Progrès dans la chirurgie des anévrismes de l'aorte abdominale.