COMPARISON OF LONG-TERM SURVIVAL AFTER REPAIR OF RUPTURED AND NONRUPTURED ABDOMINAL AORTIC-ANEURYSM

Late survival rates were compared and analysed for 1070 patients under going repair of ruptured infrarenal abdominal aortic aneurysm (RAAA, n = 364, mean age 70.0 years, male:female ratio 5.6:1)and non-ruptured abdominal aortic aneurysm (AAA, n = 706, mean age 66.6 years, male:fem ale ratio 5.4:1) between January 1970 and July 1992 at the Department of Thoracic and Cardiovascular Surgery of Helsinki University Central Hospital, Finland. There was a statistically significant difference in survival rates between the RAAA and AAA groups during the first three months after repair of abdominal aortic aneurysm. Operative mortality rates were 7.3% for electively repaired abdominal aortic aneurysms an d 48.7% for ruptured abdominal aortic aneurysms. For 3-month postopera tive survivors there existed no statistically significant difference i n late survival rates, nor did these rates differ from those of an age - and sex-matched population. Five-year survival rates for 3-month pos toperative survivors were 60% in the RAAA group and 67% in the AAA gro up. Median survival time was 5.7 years and 7.5 years, respectively. Co ronary artery disease, hypertension, chronic obstructive pulmonary dis ease and renal insufficiency statistically significantly reduced late survival rates after 3 months post-surgery for non-ruptured abdominal aortic aneurysm, whereas these risk factors did not alter late prognos is after successful repair of ruptured abdominal aortic aneurysm. Cere brovascular disease reduced late survival rates both in AAA (median su rvival lime 6.3 years) and RAAA group (median survival time 4.9 years) . Of late deaths 41% were caused by coronary artery disease in the AAA group and 38% in the RAAA group. Arteriosclerosis (coronary artery di sease, cerebrovascular accidents) was a main death cause for both grou ps: 54% in the AAA group and 49% in the RAAA group; 20% of late deaths were caused by malignancies in the AAA group and 19% in the RAAA grou p.