Repair of Ruptured Abdominal Aortic Aneurysm in Octogenarians

Abstract

Surgical mortality of ruptured aneurysm repair was not independently related to advanced age but mainly driven by cardiac disease and manifest hypovolaemic shock. An almost normal long-term prognosis of aged patients after successful repair justifies even attempts of open repair, particularly in carefully selected patients.

Recent risk factors for open surgical mortality in patients with ruptured abdominal aortic aneurysm

“…1 Previously, several factors such as age, female sex, prolonged collapsed vital phase, massive transfusion, or hemorrhage during surgery, were considered independent risk factors of mortality. [2][3][4][5][6][7][8][9][10][11] However, these results are still not definitive and some studies were published in the 1990s. Between 2006 and 2012, 57 patients received emergency surgical treatment for AAA.…”

“…6,7,17 Although the elderly patients have an increased risk of having cardiac and cerebrovascular events in the postoperative period, 8 the risk factor might not be age itself but cardiac or some other capacities of these patients. 9 Regarding the blood data, previous studies reported hemoglobin or hematocrit levels indicated the degree of hemorrhage, and elevated serum creatinine level >1.5 mg/dL correlated with adverse outcomes.…”

Endovascular suitability and outcome after open surgery for ruptured abdominal aortic aneurysm

“…The Swiss Cardiovascular Centre manages about a quarter of rAAAs in Switzerland17. In 2001, a cohort study was started to follow all patients with rAAA prospectively18. The study ran until December 2010.…”

“…The study ran until December 2010. Inclusion criteria and validation of consecutive completeness have been described previously18. In brief, all types of rAAA were captured including true, false and mycotic aneurysms at pararenal or infrarenal aortic and/or iliac level.…”

“…Patients were offered open or endovascular repair at the discretion of the attending vascular surgeon. All patients or their relatives provided written informed consent for inclusion in the cohort study as well as for anonymous analyses18, and approval for the present investigation was granted by the local ethics committee.…”