SURGICAL STRATEGY OF ABDOMINAL AORTIC-ANEURYSM WITH PREOPERATIVE RENAL-FAILURE

Objectives: To determine the effect of preoperative renal failure on t he outcome of patients suffering from infrarenal abdominal aortic aneu rysm (AAA). Method: During the period from January 1979 to August 1995 , 364 patients with AAA were admitted to our hospital and 323 underwen t elective repair. The patients were retrospectively analysed in three groups. Group I was composed of 273 patients with a normal renal func tion who underwent an aneurysm repair. Group II was composed of 50 pat ients who demonstrate a preoperative renal dysfunction (creatinine abo ve 2.0 mg/dl or creatinine clearance below 40 ml/min) and underwent an operation, including three patients maintained on chronic haemodialys is. Group III was composed of 18 patients with a renal dysfunction who did not undergo repair, including one patient maintained on chronic h aemodialysis. Results: The operative mortality rate of groups I and II were 0.4% and 2.0%, respectively, although no significant difference was observed. The incidence of postoperative cardiac and pulmonary com plications were also comparable in two groups. No patients required ac ute haemodialysis. The 5-year survival rate of group II (44%) was sign ificantly higher than that of group III (20%), and seven of the 18 pat ients (39%) in group III ultimately died of a rupture of the AAA. Conc lusions: Patients with chronic renal failure can undergo an abdominal aortic aneurysm repair based on the same indications as those without renal failure.