False Aneurysm of Abdominal Aorta

AORTIC RESECTION with prosthetic replacement has become firmly established as the definitive treatment of aortic aneurysms. In the past decade, refinements in technique, prostheses, and supportive care have markedly reduced the morbidity and mortality of aortic resection. These refinements have frequently been instigated by the critical evaluation of postoperative patients. We have recently treated four patients who developed false aneurysms due to late disruptions of aortic-prosthetic suture lines. All of these patients had elective resections of arteriosclerotic abdominal aortic aneurysms with prosthetic replacement. All developed symptoms which should have led to a diagnosis of false aneurysm had the diagnosis been considered. All died of hemorrhage due to eventual rupture of the false aneurysms. None had evidence of infection of the prosthesis. In this report we shall attempt to evaluate the pathogenesis, diagnosis, and surgical management of this unfortunate complication of aortic resection. Report of Cases Case 1. —A 66-year-old white