Repair of abdominal aortic aneurysms in high-risk patients

Today, repair of an abdominal aortic aneurysm with interposition prosthetic graft replacement is the only reliable method of preventing aneurysm rupture. The Mayo experience demonstrates that this repair also can be accomplished in high-risk patients with very acceptable morbidity and low mortality rates. However, it must be emphasized that these results are related not only to the surgical procedure itself but also to vigorous perioperative medical support, including intraoperative pharmacologic enhancement of cardiac function, intra-aortic balloon counterpulsation if necessary, and intensive postoperative pulmonary management. When resources are available for intensive intraoperative and postoperative support, direct graft repair is the treatment of choice for high-risk patients with abdominal aortic aneurysms.