SURVIVAL AND RISK-FACTORS IN PATIENTS OPE RATED ON FOR ABDOMINAL AORTIC-ANEURYSMS

Patients requiring radical cure of an aneurysm of the abdominal aorta often have associated conditions increasing the risk of peri-operative complications and immediate or short-term mortality. Detecting such a ssociated lesions is thus of major importance to adapt patient managem ent and treatment strategy. We assessed the following parameters assoc iated with increased risk of peri-operative death in a series of 418 p atients who underwent elective surgery for aneurysms of the abdominal aorta between 1986 and 1994: chronic renal failure (with or without di alysis), clinically apparent coronary artery disease, age over 75 year s, defective left ventricular function. The effect of the characterist ics of the aneurysm on immediate survival was also assessed. Aneurysm larger than 6 cm extending to the hypogastric artery had a higher oper ative risk. Post-operative survival was 96.5 % at one month, 90 % at o ne year and 87 % and 69 % at 2 and 5 years respectively. The pre-domin ant causes of death late in the post-operative period were vascular di sease (coronary or neurologic) and cancer. Complications related to th e operation were rare (1.5 %). In conclusion, detection of operative r isks allows 1) better patient selection for surgery, 2) adopting appro priate measures when the indication for surgery is retained, 3) establ ishing a follow-up and a screening protocol for detecting factors caus ing late deaths.