Impacts of major complications seen after ruptured abdominal aortic aneurysm repair surgery over mortality

Cengiz Şahutoğlu; Pelin Öztürk

doi:10.19161/etd.418131

Research Article

Rüptüre aort anevrizma tamiri cerrahisi sonrası gelişen major komplikasyonların mortalite üzerine etkisi

Year 2019, Volume: 58 Issue: 2, 103 - 107, 28.06.2019

Cengiz Şahutoğlu Pelin Öztürk

https://doi.org/10.19161/etd.418131

Abstract

Aim:
To present our management approach, complications, and mortality-related
risk factors in patients diagnosed with ruptured abdominal aortic aneurysm
(RAAA) who underwent open surgery.

Materials
and Methods: The charts of 39 patients with RAAA who
underwent open surgery between September 2010 and
August 2015 were reviewed retrospectively. Study population was divided into two
groups; Group-1 (n=14) consisted of cases who died within 30 days after surgery
and Group-2 (n=25) consisted of the survivors. Pre-,
intra-, and postoperative factors related to mortality and morbidity were noted
and statistically analyzed.

Results:
Of the 39 patients with a mean age of 68.9±9.5 years, 37 (94.9%) were males. Twelve patients with hypovolemic shock
(30.8%) were taken into operation; and
56.4% of all study participants had infrarenal aneurysms. A total of 69.2% of
the patients developed at least one complication, while 38.5% developed two or
more complications. Two patients (5.1%) died in the intraoperative period,
whereas 12 (30.8%) died within 30 days after the operation. Intraoperative
aortic cross-clamp time being over than 40 minutes, development of cardiac complications or acute renal failure, and
sepsis were found to be independent risk factors related with mortality.

Conclusion: Our study results showed that preoperative hemodynamic regulation, shortening of aortic cross-clamp time and strict
adherence to sterilization guidelines can reduce
morbidity and mortality rates in cases with RAAA underwent repair surgery.

Keywords

Anestezi, böbrek yetmezliği, komplikasyon, mortalite, rüptüre abdominal aort anevrizması.

References

Kim IH, Kim DI, Huh SH, Lee SJ, Lee BB. Factors that affect the survival rate of ruptured abdominal aortic aneurysm. J Korean Soc Vasc Surg 2001;17(2):199-202.
Noel AA, Gloviczki P, Cherry KJ Jr, et al. Ruptured abdominal aortic aneurysms: The excessive mortality rate of conventional repair. J Vasc Surg 2001;34(1):41-6.
Davies RS, Dawlatly S, Clarkson JR, Bradbury AW, Adam DJ. Outcome in patients requiring renal replacement therapy after open surgical repair for ruptured abdominal aortic aneurysm. Vasc Endovascular Surg 2010;44(3):170-3.
Scarcello E, Ferrari M, Rossi G, et al. A new preoperative predictor of outcome in ruptured abdominal aortic aneurysms: the time before shock (TBS). Ann Vasc Surg 2010;24(3):315-20.
Halpern VJ, Kline RG, D’Angelo AJ, Cohen JR. Factors that af¬fect the survival rate of patients with ruptured abdominal aortic aneurysms. J Vasc Surg 1997;26(6):939-45.
Leonard A, Thompson J. Anaesthesia for ruptured abdominal aortic aneurysm. Contin Educ Anaesth Crit Care Pain 2008;8(1):11-5.
Kauvar DS, Sarfati MR, Kraiss LW. Intraoperative blood product resuscitation and mortality in ruptured abdominal aortic aneurysm. J Vasc Surg 2012;55(3):688-92.
Cho MJ, Yoon HJ, Park JY, Huh S, Kim YW. The risk factors influencing postoperative mortality in the patients with ruptured abdominal aortic aneurysm. J Korean Soc Vasc Surg 2004;20(2):208-13.
Boyle JR, Gibbs PJ, King D, Shearman CP, Raptis S, Phillips MJ. Predicting outcome in ruptured abdominal aortic aneurysm: A prospective study of 100 consecutive cases. Eur J Vasc Endovasc Surg 2003;26(6):607-11.
Grant SW, Grayson AD, Grant MJ, Purkayastha D, McCollum CN. What are the risk factors for renal failure following open elective abdominal aortic aneurysm repair? Eur J Vasc Endovasc Surg 2012;43(2):182-7.
Kim SD, Hwang JK, Park SC, et al. Predictors of postoperative mortality of ruptured abdominal aortic aneurysm: A retrospective clinical study. Yonsei Med J 2012;53(4):772-80.
Mell MW, O’Neil AS, Callcut RA, et al. Effect of early plasma transfusion on mortality in patients with ruptured abdominal aortic aneurysm. Surgery 2010;148(5):955-62.
Roberts K, Revell M, Youssef H, Bradbury AW, Adam DJ. Hypotensive resuscitation in patients with ruptured abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 2006;31(4):339-44.