Document Detail

Advances in the surgical repair of ruptured abdominal aortic aneurysms.
MedLine Citation:
PMID:  9012998     Owner:  NLM     Status:  MEDLINE    
Over the past two decades, the mortality rate for elective repair of infrarenal abdominal aortic aneurysms has improved to an acceptable level (< 5%). However, surgical results of ruptured abdominal aortic aneurysms have remained fairly constant with about 50% in hospital mortality rates. Growing experience with the use of the left retroperitoneal exposure for elective aortic surgery allowed the authors to extend the use of this technique to the repair of ruptured abdominal aortic aneurysm. The extended left retroperitoneal approach using a posterolateral exposure through the 10th intercostal space allowed the surgeon expeditiously and reliably to obtain supraceliac aortic control by dividing the left crus of the diaphragm in all patients. In total, 104 aortic replacements were performed for ruptured abdominal aortic aneurysm during the past 7 years. Of these patients, 87 were men and 17 women; mean(range) age was 72(52-95) years. Hemodynamic instability (as defined by a systolic blood pressure of < 90 mmHg) was present before surgery in 41% (43/104) of patients. The operative mortality rate was 27.9% (29/104). Preoperative hemodynamic instability, time of operative delay and aortic cross-clamp time did not correlate with operative mortality. The median duration of intensive care unit stay was 4 (range 1-60) days and hospital stay 11 (range 6-175) days. The results of this series identified that a change in the operative technique for the repair of ruptured abdominal aortic aneurysm beneficially affected patient survival. The authors suggest that expeditious supraceliac control without thoracotomy is an excellent alternative and offers an advantage in the surgical management of ruptured abdominal aortic aneurysm.
R C Darling; J A Cordero; B B Chang; D M Shah; P S Paty; W E Lloyd; R P Leather
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  4     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-04-29     Completed Date:  1997-04-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  720-3     Citation Subset:  IM    
Vascular Surgery Section, Albany Medical College, New York 12208, USA.
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MeSH Terms
Aged, 80 and over
Aortic Aneurysm, Abdominal / mortality,  surgery*
Aortic Rupture / mortality,  surgery*
Blood Vessel Prosthesis / methods*,  mortality
Middle Aged
Surgical Procedures, Elective
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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