복부 대동맥류 수술의 임상적 고찰

Abstract

Background: Surgery of abdominal aortic aneurysm revealed high operative mortality. We reviewed our 11-years’ experiences of abdominal aortic aneurysm operation and wish to obtain information on the treatment. Material and Method: From Jan. 1990 to Dec. 2000, 48 patients were operated due to abdominal aortic aneurysm in Yonsei Cardiovascular Center. Mean age was 62.8±12.7 and there were 40 males and 8 females. Among 48 patients, nine patients had ruptured abdominal aortic aneurysm, and mean aneurysm diameter of non-ruptured cases was 8.8±2.4 ㎝. Result: There were 6 early deaths, and early mortality was 12.5%. Among 9 patients of preoperative aneurysm rupture, three patients died (33.3%), and among 39 patients of non-ruptured cases, 3 patients died (7.7%). Among preoperative variables, age (p＜0.05), preoperative BUN level (p＜0.05), and DM (p＜0.05) were risk factors of early mortality. Among discharged 42 patients, 40 patients were followed up (f/u rate=95.2%) and mean follow up was 3.6±0.2 years. During follow up periods, five patients died (late mortality=11.9%), and Kaplan-Meier survival analysis revealed 81.7±7.6% survival rate at five and ten year. Linealized incidence of graft related event was 3.53% per patient-year. Conclusion: Surgical mortality of ruptured abdominal aortic aneurysm was higher than non-ruptured cases; therefore, early resection of the aneurysm can decrease the surgical mortality.