Surgical Treatment of the Aortic Aneurysm

Kim, Hak Jae; Jo, Won Min; Kim, Tae Sik; Lee, Song Ahm; Kim, Oug Jin; Son, Young Sang; Choi, Young Ho

Abstract

Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation (Sx-Op), the duration from admission to operation (Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm (10 cases), abdominal aortic aneurysm (9 cases), Marfan's syndrome (3 cases), descending thoracic aortic aneurysm (3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months (mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.