Objective: To study the early mortality and major complications of infrarenal abdominal aortic aneurysm (AAA) repair.
Methods: One hundred and eighty-six cases of infrarenal AAA, which underwent surgery in our hospital between January 1988 and December 2000, were selected. Early mortality and major complications were rated, and preoperative cardiac, pulmonary and renal condition, age and surgical impact were taken into account while evaluating the risk factors of early mortality and major complications.
Results: The early mortality was 5.0% for elective surgery and 57.1% for ruptured surgery. The early major complication rate for AAA repair was 18.4% in total, and 10.6%, 11.2%, 2.8%, 1.1% for cardiac complication, pulmonary complication, acute renal failure, stroke and hepatic insufficiency respectively. Coronary heart disease significantly predisposed the patients to the development of cardiac complications (chi 2 = 19.737, P < 0.01) while hypertension had no such effect (chi 2 = 1.870, P > 0.05). Abnormal pulmonary function, smoking and PaO2 less than 80 mmHg were responsible for postoperative pneumonia(chi 2 = 4.051, 5.885 and 5.162, P < 0.05), but not for adult respiratory distress syndrome(chi 2 = 0.127, 0.916 and 1.067, P > 0.05). Preoperative renal function was not related postoperative acute renal failure(chi 2 = 0.404, P > 0.05). Age more than 70 years or operation spanned more than 5 hours increased major complications(chi 2 = 16.119 and 10.163, P < 0.01) and early mortality(chi 2 = 16.119 and 10.163, P < 0.01).
Conclusions: Multiple system organ failure is the leading cause of early mortality of AAA repair. Cardiac and pulmonary complications are commonly seen after AAA repair. Preoperative cardiac, pulmonary condition, age and surgical aspects greatly influence the early mortality and major complications.