RUPTURED ANEURYSMS OF THE THORACOABDOMINAL AORTA - A CASE SERIES

Fifteen cases of ruptured thoracoabdominal aneurysm (TAA) were encount ered in 1987-July 1994, These patients included 13 males (86.6%), 2 fe males (13.4%) with a mean age of 66.3 years (range 58-78), Surgery was performed on 13 patients of whom 6 (46.1%) died within 30 days, The t wo other patients had died of heart failure prior to surgery. In 8 of these patients (53.4%) the condition was not diagnosed until dear symp toms had appeared, The ruptured aneurysms were thoracic in 9 cases (60 %), abdominal in 6 (40%). The maximum aneurysm diameter in the most fr equently ruptured group was 6.1-8 cm (in 9 patients - 60%), For 5 case s (33.4%) the maximum diameter of ruptured aneurysms included dorsolum bar pain, In one patient a concomitant aortobronchial fistula had prod uced rupture. Low blood pressure was found in 9 cases (60%), In 5 case s (38.4%) curative surgery was performed within 24 hours of the onset of symptoms, In this group, the mortality rate was 40% (2 patients), I n the remaining 8 cases, on whom surgery could not be performed within 24 hours (range 25 hours - 4 months) the mortality rate was 50% (4 ca ses). All four cases of paraplegia (30.7%) were encountered among pati ents in the second group, 2 of whom died, Follow-up revealed a 5-year mortality rate of 71.4%.