This study was undertaken to examine the longterm survival rates of patient
s following abdominal aortic aneurysm (AAA) repair in comparison with an ag
e-matched normal population, and to determine by multivariate analysis the
factors influencing long-term survival. Of 125 patients who underwent AAA r
epair prior to July 1986, 13 died during hospitalization. Of these 13 patie
nts, 6 who suffered aneurysmal rupture all died within 30 days. The surviva
l rate of patients with ruptured aortic aneurysms was significantly lower t
han that of those with nonruptured aneurysms. Of the 112 patients surviving
hospitalization, 85 died within 0.38 to 24 years after their operation, Th
e long-term survival rate of patients who had suffered a preoperative cardi
ovascular event was significantly lower than that of those who had not suff
ered a preoperative cardiovascular event. The actual survival rate was sign
ificantly lower than the expected survival rate. According to a multivariat
e analysis, the significant predictors of late survival were age, aneurysma
l rupture, and chronic renal failure in all the patients, and age, chronic
renal failure, and pre- and postoperative cardiovascular events in patients
who did not die in hospital. These findings indicate the importance of imp
roving immediate perioperative management of ruptured, AAA and that cardiov
ascular events should be prevented, or treated during long-term follow-up.