Prognosis and treatment of abdominal aortic aneurysm.

The records of 109 patients operated upon for ruptured or nonruptured abdominal aortic aneurysms in the period from 1961 to 1975 were analyzed, with special attention being given to hospital mortality and the long term survival rate. It was found that a hospital mortality of 67 per cent occurred in patients operated upon for ruptured aortic aneurysms as well as a lethality rate of 40 per cent for patients operated upon urgently for nonruptured aortic aneurysms, whereas the lethality rate was only 4.5 per cent for patients operated upon electively. Subsequent to surgical treatment, an imposingly high mortality occurred in both groups of patients in relation to the normal population, so that only about 10 per cent of the patients operated upon for abdominal aortic aneurysms were living after a period of eight years. The most frequent causes of death in both groups of patients were illnesses resulting from other cardiovascular manifestations or complications in connection with the implanted prosthesis. By optional operation of the nonruptured aortic aneurysm, a gain in the number of patient years could be obtained within the first five years after the operation. However, careful evaluation of the cardiovascular status of the patient is recommended before deciding upon an operation.