Mortaliteit van electieve chirurgie bij aneurysma’s van de abdominale aorta

Objective

Assessment of postoperative mortality in patients undergoing elective surgery for asymptomatic abdominal aorta aneurysm (AAA) in the Academic Medical Center (AMC), Amsterdam, the Netherlands. This is compared with national statistical information and data in the literature.

Design

Retrospective cohort study.

Method

Retrospective analysis of all patients who underwent an elective open or endovascular intervention in connection with asymptomatic aneurysm of the infrarenal abdominal aorta ≥ 5.5 cm in the period 2004-2010.

Results

In the study period 234 patients were electively operated for an abdominal aorta aneurysm (129 conventional and 104 endovascular interventions). In this period, 3 (1.3%) patients died in hospital or within 30 days of the intervention. Of the 73 patients ≥ 75 years of age, 2 (2.7%) died. None of the deceased patients were treated endovascularly.

Conclusion

The figures presented for elective aneurysm surgery in the AMC are favourable in comparison with the published national mortality statistics of over 10% morality in patients ≥ 75 years of age. Because of the lack of randomized trials for treatment of aneurysms ≥ 5.5 cm there are many uncertainties concerning survival benefit obtained by operation. It is important for each clinic to arrange the care for elective aneurysm surgery in such a way that mortality is minimal. Important factors to achieve this are a well-attuned treatment team and careful patient selection.

Conflict of interest: the institute for which D.A. Legemate is working received private funding from the AMC Foundation for research on aneurysms. Financial support for this article: none indicated.