Ruptured abdominal aortic aneurysms. Surgical treatment.

The records of 62 consecutive patients with ruptured abdominal aortic aneurysms were analyzed to determine what factors contribute to lower mortality. Survival was directly related to the immediate preoperative hemodynamic status of the patients. In 18 cases in which operation was carried out with patients stable, 83 percent of the patients survived. Even if shock was present by the time of operation (37 cases), a 68 percent survival rate was achieved. Cardiac arrest occurred before obtaining aortic control in seven patients and one survived. Survival rates were increased if certain preoperative, operative and postoperative guidelines were followed. Since the combined operative mortality and late graft failure rate in 125 elective aneurysmectomies done during the same decade was under 5 percent, all abdominal aortic aneurysms with few exceptions should be surgically treated before rupture occurs.