The long-term follow-up results of elective surgical treatment for abdominal aortic aneurysms.

This study was aimed at evaluating early and long-term follow-up results of surgical reconstruction of infrarenal abdominal aortic aneurysms (AAA). A consecutive series of 392 patients who underwent elective abdominal aortic repair from 1974 to 2000 was reviewed retrospectively. The mean age was 69.8 years (range 34-90), with 329 males and 63 females. The hospital mortality rate was 3.8% (15/392). Of the 203 patients that died during the follow-up period, 28% (56/203) were due to atherosclerotic diseases and 25% (51/203) were malignancies. The Patients whom underwent AAA surgery associated with ischemic heart disease had a 5-, 10-, and 15-year survival rate of 62%, 30%, and 9%, respectively. On the other hand, a survival rate of those not associated with ischemic heart disease were 71%, 38%, and 16%. The patients associated with aortoiliac occlusive disease in AAA surgery had a 5-, 10-, and 15-year survival rate of 51%, 11%, and 0%; those without aortoiliac occlusive disease had a survival rate of 72%, 43%, and 18%, respectively. There were statistically significant differences between the ischemic heart disease and the non-ischemic heart disease, the aortoiliac occlusive disease and the non-aortoiliac occlusive disease in long-term survival rates respectively. These findings demonstrate that AAA patients associated with ischemic heart disease or aortoiliac occlusive disease are at a higher risk than those with AAA alone. Therefore, AAA patients with aortoiliac occlusive disease and or ischemic heart disease should be managed more intensively before, during and after the operation.