Abdominal aortic aneurysm, an absolute surgical indication?
In a retrospective study, 155 patients operated for infrarenal abdominal aortic aneurysm during a 5.5-year period (jan. 1986-->oct. 1991) were reviewed. In our series, 111 patients underwent elective (EL) surgery, 44 patients had an emergency (EM) operation. Male/female ratio was 10/1. Mean age in the EL group and EM was 68.1 years and 71.82 years respectively (p < 0.05). In the EL group, 68 (= 61%) patients were asymptomatic. All patients in the EM group had symptoms: shock + syncope in 28 patients, acute back pain in 4 patients, acute abdominal pain in 12 patients. Aneurysm diameter > or = 8 cm was present in 33% of the EL group, but in 57% of the EM group. Early mortality for the EL and EM group was 3.6% and 23% respectively (p < 0.001). Major postoperative complications were present in 13% in the EL group, in 55% in the EM group (p < 0.001). During a 5-year follow-up of 135 patients (= 96%), 22 patients died. Cardiac problems (7/22) and cancer (5/22) were most prominent. 5-year survival for the entire group was 83%; EL (85%) and EM (76%) were not significant. None of the patients subsequently underwent an operation related to the abdominal aortic intervention.
Dossche
K
K
Departement Cardiovascular Surgery, Onze Lieve Vrouwziekenhuis, Aalst, Belgium.
Hessmann
M
M
Wellens
F
F
Vanermen
H
H
De Geest
R
R
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D015996:Survival Rate