Results of Transabdominal Emergency Repair of Ruptured Abdominal Aortic Aneurysms

• Published in: Nihon Kyukyu Igakukai Zasshi 2000/12/15, Vol.11(12), pp.679-682
• Main Authors: Sako, Hidenori, Hadama, Tetsuo, Shigemitsu, Osamu, Miyamoto, Shinji, Anai, Hirofumi, Urabe, Shougo, Wada, Tomoyuki
• Format: Article
• Language: English
• Subjects: intra-luminal anastomosis; prosthetic graft replacement; ruptured abdominal aortic aneurysm
• ISSN: 0915-924X; 1883-3772
• DOI: 10.3893/jjaam.11.679

Abdominal aortic aneurysm (AAA) rupture has historically been associated with high mortality rates. In our institution, the approach and surgical procedure for ruptured AAA has been the same as for elective repair of asymptomatic AAA, and the primary aim of the operations has been to place the infrarenal abdominal aortic clamp as quickly as possible after laparotomy in rupture cases. Between January 1981 and December 1999, 286 patients underwent AAA repair, including 61 (21.3%) who were operated for ruptured AAA. Operative mortality was 0.4% (1/225) in the elective cases and 26.2% (16/61) in the ruptured cases. The causes of death in the ruptured cases were: 6 deaths on the table or the next day without recovering from preoperative shock, 4 deaths of multiple organ failure, one death of pneumonia caused by MRSA, 3 deaths from myocardial infarction, and 2 from thoracic aortic aneurysm rupture during the hospital stay. The most important maneuver is placing the infrarenal abdominal aortic clamp as quickly as possible after laparotomy in order to shorten the duration of preoperative shock.