CHANGING TRENDS IN THE OUTCOME OF URGENT ANEURYSMS SURGERY - A RETROSPECTIVE STUDY ON 170 PATIENTS TREATED IN THE YEARS 1966-1990

During the last 25 years 170 patients with ruptured aortic aneurysms w ere treated in our centre for vascular surgery with an overall mortali ty of 54%. We have subdivided these patients into three groups accordi ng to temporal factors: the 1st group includes 16 patients treated in the years 1966-1978; the 2nd group includes 93 patients treated from 1 979 to 1987; the 3rd group includes patients from 1988 to 1990. In the se years no selection of patients was made and everybody still alive w as operated on. Starting from the second period, haemodynamical monito ring of the patients was performed with the adoption of the Swan-Ganz catheter in almost all cases. Mortality in the first period was 69%, i n the second period 60% and in the third period 40%. There was no diff erence in the haemodynamical state in the three groups. The difference lies in the number of surgical interventions per year: 1.33 intervent ion per year in the first period; 11.625 interventions per year in the second period and 20 in the third. We conclude that an improvement in the survival rate of patients undergoing urgent aortic aneurysm repai r is due to precise haemodynamical intraoperative monitoring and a wel l trained surgical team.