Ten-year results following elective surgery for abdominal aortic aneurysm.

Abstract

OBJECTIVE: 10-year results after elective operation for infrarenal aortic aneurysm considering the influence of risk factors. EXPERIMENTAL DESIGN: Retrospective study with 5-12 year postoperative follow-up. SETTING: University hospital (Klinikum Grosshadern, Munich). PATIENTS: The long-term follow-up was based on 521 (95.6%) out of 545 consecutive patients operated upon electively for abdominal aortic aneurysm between 1978 and 1987. INTERVENTIONS: The infrarenal aneurysms were excluded by aortic tube grafts (314 patients, 59%) or bifurcation grafts (231 patients, 41%). MEASURES: The birthday, operation day and eventually the day of death in the hospital were documented in the charts. The patient's state or cause of death were elicited on the phone 5 to 12 years after the operation. Kaplan-Meier survival curves were calculated based on these data and compared to age-matched normal male populations. RESULTS: Hospital mortality was 6.4%. The cumulative rate of survival following elective surgery was 65% at 5 years and 41% at 10 years, the mean survival time being 95.1 months. Age, coronary artery disease and hypertension had a significant influence on the cumulative survival. Patients with aorto-coronary bypass had a better long-term outcome than those without bypass surgery. CONCLUSIONS: The excellent long-term results within a high-risk population support elective surgery of infrarenal aortic aneurysms. Results of new interventional techniques will have to be compared with this "golden standard" follow-up.