| 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) |
|
