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[Aorto-iliac aneurysms rupturing into the vena cava. A retrospective multicenter study]
1Service de Chirurgie Thoracique et Cardio-Vasculaire, CHU Côte de Nacre, 14033 Caen Cedex. maiza-d@chu-caen.fr
Journal Des Maladies Vasculaires
|May 11, 2000
Summary
Ruptured abdominal aortic aneurysms into the vena cava present with varied symptoms. Early diagnosis and surgical repair are crucial, though perioperative mortality remains high, often due to cardiac and respiratory complications.
Area of Science:
- Vascular Surgery
- Cardiovascular Research
- Surgical Outcomes
Context:
- Retrospective analysis of 39 cases of abdominal aortic aneurysms ruptured into the vena cava.
- Data collected from 11 centers of the French inter-university association for surgical research (AURC) between 1979 and 1989.
Purpose:
- To investigate the clinical presentation, diagnostic delay, surgical management, and outcomes of patients with abdominal aortic aneurysms ruptured into the vena cava.
Summary:
- Varied signs and symptoms were observed, with the classic triad present in only one-third of cases. Preoperative diagnosis was achieved in 74.4% of patients, with a mean delay of 7 hours from symptom onset.
- Surgical repair involved direct venous suture in 76% of cases, with significant peroperative blood loss (4600 ± 3500 ml).
- Perioperative mortality was 28.2% (11 cases), with cardiac and respiratory disorders accounting for 54.4% of fatalities.
Impact:
- Highlights the challenges in diagnosing and managing this rare but severe complication of abdominal aortic aneurysms.
- Underscores the need for improved diagnostic strategies and perioperative care to reduce mortality, particularly concerning cardiac and respiratory complications.