Frequency and Patterns of the Early Postoperative Complications after Abdominal Aortic Surgery

Kim, Tae Bong; Kim, Young Wook

Abstract

While the results of abdominal aortic surgery has been improving, it still remained as an operation which can be accompanied by serious complications leading to operative mortality. During the period of 4 years and 8 months, we performed 86 abdominal aortic operations for the patients with abdominal aortic aneurysm(AAA, n=44), aortoiliac occlusive disease(AIOD, n=40), and traumatic aortic injury (n=2). To review the early postoperative (<30 days) complications and mortality, 84 patients with AAA and AIOD were included in this study. Operation procedures for the 84 patients were implantation of 73 bifurcated and 9 tube aortic grafts, and 1 aortic thromboendarterectomy, and 1 transaortic suture closure of aneurysmal neck for the patient with saccular aneurysm at the suprarenal aortic segment. The early postoperative complications were categorized as local vascular, local non-vascular, remote vascular, and systemic complications from beginning of this study. Retrospective review of complication data was performed in 4 groups of patients: Emergent AAA group (n=18), Elective AAA group (n=26), Emergent AIOD group (n=6), and Elective AIOD group (n=34). The frequencies of early postoperative systemic complications were 37.5% and 10% after emergent and elective aortic surgery, respectively. The frequency of major systemic complications following AAA repair was respiratory (5/18, 27.8%), renal (4/18, 22.2%) complications in emergent AAA group and cardiac (2/26, 7.6%), respiratory (1/26, 3.8%), and renal (1/26, 3.8%) compliations in elctive AAA group. The frequency of major systemic complication following AIOD surgery were renal (2/6, 33.3%), cardiac complication (1/6, 16.7%) in emergent AIOD group and respiratoy (3/34, 8.8%) complication in elective AIOD group. Three (3.6%) serious cardiac complications resulting in 1 mortality developed after all abdominal aortic operations. Four operative mortality (overall mortality rate: 4.8%) occurred in in emergent AAA group (2/18, 11.1%) and in emergent AIOD group (2/6, 33.3%). There occurred no operative mortality in the elective surgery group.