Abdominal aortic aneurysms in Hong Kong

Abstract

The experience of managing abdominal aortic aneurysms in a teaching hospital in Hong Kong over a 15-year period is reviewed. The ratio of elective to rupture aneurysm was three to one. The mortality of 90 elective aneurysmectomies was 9% and the main cause of death was myocardial infarction. Mortality was affected by the pre-operative respiratory and renal status of the patient, and the need for postoperative ventilatory support; thus, a careful evaluation of the renal and respiratory status for elective aneurysmectomy may further improve the hospital mortality. In 68 emergency operations for ruptured aneurysms, the operative mortality was 46%. The significant determinants of mortality for ruptured aneurysms were the duration of intra-operative hypotension (> 15 minutes) and the systolic pressure at completion (< 120 mmHg); this was especially true for early operative death. The pre- and postoperative patient factors were less significant for ruptured cases than for elective ones; operations should be offered to every patient with ruptured aneurysm if possible.