COMPLICATIONS OF STANDARD ELECTIVE ABDOMINAL AORTIC-ANEURYSM REPAIR

Objective: To evaluate complications of standard elective repair of in frarenal abdominal aortic aneurysms. Design: Prospective multicentre s tudy. Materials: Two-hundred and ninety-one consecutive patients under going standard elective surgery for an infrarenal aortic aneurysm. Met hods: Recording adverse events according to the recommendations of the Ad Hoc Committee on Reporting Standards. Results: Seventy-five patien ts (26%) experienced some complication following elective aortic aneur ysm surgery. Twenty- two patients had a mild complication (7.6%, 95% C .I. 4.8-11.2%), 27 a moderate (9.3%, 95% C.I. 6.2-13.2%) and 26 patien ts had a severe and/or fatal complication (8.9%, 95% C.I. 5.9-12.8%). The in-hospital mortality was 4.1% (12 patients, 95% C.I. 2.2-7.1%). C ardiac failure teas the commonest primary cause for death (58%). Twent y-two per cent of the patients had a non-fatal complication: the most frequent being pulmonary (10%) and cardiac (10%). Patients with a hist ory of cardiac events had a five limes higher risk of a fatal outcome (95% C.I. 1.1-24.0) and a two and a half rimes higher risk of any seve re fatal or non-fatal complication (95% C.I. 1.0-6.5). Other risk fact ors were advancing age and the presence of pulmonary disease. Conclusi ons: In addition to mortality, morbidity figures of standard aneurysm operations are important, as well as associated risk factors. This is especially rue when evaluating early repair of small aneurysms and new endovascular techniques.