ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Factors that influence postoperative recovery in grade1-2 symptomatic ruptured abdominal aortic aneurysms
Cenk Erdal, Erdem Silistreli, Özalp Karabay, Hüdai Çatalyürek, Emel Fermancı, Ünal Açıkel
Dokuz Eylül Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir
Background: This study sought to determine factors that influence recovery following an emergency operation for grade 1-2 symptomatic ruptured abdominal aneurysms.

Methods: Eighteen patients (12 males, 6 females; mean age 70±7 years; range 55 to 80 years) underwent an emergency operation for grade 1-2 symptomatic ruptured aortic aneurysms. Grade 3-4 symptomatic patients were excluded. Suprarenal cross-clamping was applied in six patients in whom the renal arteries were involved. An aortobifemoral bypass was performed using a PTFE graft. The effect of preoperative systemic diseases, operation time, and cross-clamp levels on recovery was evaluated.

Results: The mean time from admission to surgery was 90±25 minutes, the mean operation time was 120±30 minutes, and the mean hospital stay was 14.7±5.3 days. Time from admission to surgery and operation time did not affect recovery significantly (p>0.05). At least one systemic disease was present in each patient, but none had a significant effect on recovery (p>0.05). The mean suprarenal cross-clamp time was 38±7 minutes. The level of suprarenal cross-clamping had significant influence on late recovery (p<0.002). Postoperative mortality was seen in one patient (5.6%). Complications were observed in six patients, the most common being renal dysfunction (n=4, 66.7%) and prolonged ventilator support (n=2, 33.3%). The patients who developed renal dysfunction were those in whom suprarenal cross-clamping was applied. Two patients (11.1%) required revision due to postoperative hemorrhage.

Conclusion: Our data show that the presence of systemic diseases, time from admission to surgery, and operation time do not have a significant effect on recovery, but suprarenal cross-clamping is associated with delayed recovery.

Keywords : Aorta, abdominal/surgery; aortic aneurysm, abdominal/ surgery; aortic rupture/complications/surgery; postoperative complications
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