The advantage of early operation for abdominal aortic aneurysm.

Factors affecting mortality in 493 consecutive patients undergoing operation for abdominal aortic aneurysms (AAAs) over a five-year period were analyzed. Cases were divided into three categories, based on clinical appearance: asymptomatic, symptomatic but unruptured, and ruptured. Patient age, relevant associated diseases, aneurysm size, conduct of the operation, mortality, and causes of death were reviewed and compared. Characteristics related to mortality were patient age and aneurysm size. In patients under 70 years of age, operated on electively, mortality was under 1% (two deaths in 242 patients). There were no deaths in 67 patients with aneurysms measuring 5 cm or less. Mortality increased as the aneurysms became larger and the patient older. We believe that elective operation for small asymptomatic aneurysms in younger patients will result in further reduction of morbidity and mortality associated with repair of AAAs.