Long-Term Results after Surgery for Abdominal Aortic Aneurysm

Masahiko Ikebuchi Kengo Nishimura Maromi Tachibana
Teruo Maeda Yasushi Kanaoka Shigetsugu Ohgi

(Second Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan)

We evaluated long-term survival and morbidity of 191 patients (161 non-ruptured and 30 ruptured) undergoing abdominal aortic aneurysm repair between 1980 and 1997. Thirty-day mortality rates of non-ruptured and ruptured aneurysms were 1.2% and 36.6%, respectively. Hospital death occurred in 3.1% of patients with non-ruptured aneurysms and 53.3% of those with ruptured aneurysms. Cumulative survival rates after successful AAA repair at 5 and 10 years were 76.3% and 42.3%, respectively. These were lower than survival rates in the age- and gender-matched general population. The most frequent cause of late death was cardiac problems (28.8%) including myocardial infarction. Other causes included stroke (19.2%), malignant neoplasm (17.3%), and ruptured recurrent aneurysms at or above the proximal anastomosis (9.6%) including aorto-enteric fistulas. Regarding late vascular complications, recurrent aneurysms at or above the proximal anastomosis were found in 10% of patients, including 3.5% of true aneurysms, 4.7% of anastomotic aneurysms, and 1.8% of aorto-enteric fistulas. Thoracic aortic aneurysms were found in 3.7% and aortic dissection in 4.2%. Cumulative graft patency rates at 10 and 15 years were 97.4% and 90.9%, respectively. Suppressive treatment for arteriosclerosis and continuous careful follow-up with an aggressive diagnostic approach may reduce morbidity and mortality from recurrent aneurysms or coronary artery disease, thereby improving late survival after AAA surgery.
@@Jpn. J. Cardiovasc. Surg. 31: 100-104 (2002)