Prognosis after graft replacement operation for abdominal aortic aneurysm.

We analyze findings on the long-term survival of patients undergoing elective graft replacement operations for abdominal aortic aneurysm. We review the principal surgical case series published in peer-reviewed, English-language journals over the past 15 years. Preoperative mortality was 4.0%, and 5-year survival was 69% in 16 reviewed studies encompassing 4,288 patients. Articles on late survival have largely focused on the preoperative assessment of coronary artery disease in patients who are candidates for aortic resection. The influence of other recognized risk factors, such as advanced age, hypertension, cerebrovascular disease, congestive heart failure, diabetes mellitus, and multiple aneurysms, is often not well specified in these studies. As a greater number of older patients with abdominal aortic aneurysm are seen with serious associated disease, knowledge about the expected survival of patients with surgically treated aneurysms is becoming more important to both primary care physicians and vascular surgeons when eliciting patient preferences for surgical treatment.