[Aneurysms of the abdominal aorta]

The authors present the experience of the Plzen department with treatment of aneurysms of the abdominal aorta (AAA) during the last five-year period (1992-1996) when they operated a total of 111 AAA in patients with an average age of 67.9 years (44-91 years). The number of symptomatic AAA was 15 (13.5%), 36 ruptures (32.4%). The most frequent risk factor was ischemic heart disease (IHD) in 74 (66.7%) and hypertension in 47 (42.3%) of the patients. Within 30 days after surgery two asymptomatic patients died (3.9%) and three (20%) with symptomatic AAA. The most frequent cause of death was acute myocardial infarction (AIM) in four (80%). Of 36 patients with rupture of AAA 17 (47.2%) died. A statistically significant factor for death of patients with rupture of the AAA was sever shock (blood pressure < 40 mm Hg) before surgery (p < 0.01), blood in the abdominal cavity (p < 0.01) and hypertension in the patient's case history (p < 0.05). Aimed screening of AAA in patients of risk groups and early elective surgery are important for reducing the incidence of ruptures of AAA. A patient with rupture of the AAA needs surgery urgently and unnecessary examination (CT, USG) frequently causes delay and reduces the patient's chance of survival.