[Simple vs bifurcated graft operations in patients with abdominal aortic aneurysm]. / Proteza prosta vs proteza rozwidlona w operacjach tetniaków aorty brzusznej.

We analysed 148 patients treated surgically from 1992-1997 because of abdominal aortic aneurysm (AAA). All patients were divided into two groups: group I--118 (79.7%) patients operated with the implantation of the straight graft and group II--30(20.3%) with the bifurcated graft. The aim of the study was to analyse early (30 days after operation) complications in both groups. The mortality rate was 8.5% for group I and 26.7% for group II. The mortality was also analysed according to AAA symptoms (asymptomatic, symptomatic and ruptured). The death rate in asymptomatic patients from group I was 1.1% versus 13.3% in group II. In symptomatic patients the difference was not statistically significant--20% in group I versus 22.2% in group II. The mortality rate in patients with ruptured AAA was 50% for group I and 66.7% for group II. The early morbidity rate was significantly higher in the second group(p < 0.05) although coexisting diseases were similar for both groups. According to our material we conclude, that operation of AAA should be finished in abdomen if there is only technical possibility. It is especially important for patients with ruptured AAA.

[Complication risk after abdominal aortic aneurysm operations]. / Ryzyko powiklan pooperacyjnych tetniaków aorty brzusznej.

Between 1992-1997 185 patients were treated in our Department because of abdominal aortic aneurysm (AAA). The aim of the study was the evaluation of frequency of hospital mortality (30 days) in patients treated because of AAA. One hundred forty eight (80%) patients were operated on and 37 (20%) were treated classically. The surgical group of 148 patients were divided into three parts: group I: 106 patients with asymptomatic AAA, group II: 24 patients with symptomatic AAA and group III: 18 patients with ruptured AAA. Straight graft was performed in 118 patients (79.7%) with hospital mortality rate 8.5% and bifurcated graft implanted in 30 patients with mortality rate 26.7%. Analysis of our material allowed to find that hospital mortality was in group I: 2.8%, group II: 20.8% and in group III: 55.6%. The main cause of deaths in patients from groups I and II was myocardial infarction and hypovolemic shock in group III. The most common postoperative general complications were cardiac and pulmonary and were significantly more often in group III (p < .05). Other not significantly registered postoperative complications as renal insufficiency were also more common in patients from group III. Analysis of our material revealed that patients with abdominal aortic aneurysm should be operated selectively, when aneurysm diameter reaches 50 mm, and optimal method is straight graft which allows to reduce to minimum postoperative complications.