Complications of surgery of the abdominal aorta.

Surgery of the aorta has become a routine since Astley Cooper first attempted to ligate the aorta. It is major surgery that requires careful technic, understanding of the disease process, and a full knowledge of the complications that may ensue. Most of the complications are preventable, and if the operator recognizes their possibility, most can be prevented. When complications occur, the operator must be prepared to handle them immediately since most of them are catastrophic and usually life-threatening to the patient. Surgery of the aorta should never be performed in a hospital that does not have the backup facilities to manage these complications. This requires the immediate availability of large quantities of blood and the various clotting factors that may be necessary in some patients. In addition, arteriography must be available constantly and on a moment's notice, because it is often necessary in making the diagnosis. Finally, a good intensive care unit with skilled respiratory therapists is mandatory in handling the complications of this type of operation. Many such patients have had at least one myocardial infarction before operation on the aorta and many of the complications will lead to massive distension of the abdomen with high diaphragm, atelectasis, and the need for continual respiratory care if the patient is to survive.