Abdominal aortic aneurysms ruptured into the vena cava. A retrospective multicenter study.

Eleven of the 28 centers participating in the French interuniversity associ ation for surgical research (AURC) collected retrospective data on abdomina l aortic aneurysms ruptured into the vena cava. Thirty-nine cases were obse rved between 1979 and 1989. The signs and symptoms reported varied greatly. The pathognomonic triad associating aneurysm, abdominal pain and continuou s abdominal murmur was found in one-third of the cases: 25.6% of the patien ts had signs of global heart failure. The diagnosis was preoperative in 74. 4% of the cases. Mean delay of symptomatology before diagnosis was 7 +/- 12 hours. The analysis of operative procedures included 37 patients as 2 pati ents died before vascular repair could be attempted. Venous repair was done by direct suture in 76% of the cases. Peroperative blood loss was 4 600 +/ - 3 500 mi. Perioperative mortality was 11 cases (28.2%). Cardiac and respi ratory disorders were the cause of death in 54.4% of the fatal cases.