Abdominal Aortic Aneurysms in Elderly Patients

A retrospective review of the morbidity and mortality of repair of abdominal aortic aneurysms in elderly patients was performed. Between 1975 and 1984, 104 patients older than 70 years of age (average 76.3 years) were operated upon for abdominal aortic aneurysm. Of these, 65 had elective operations, 16 had expanding aneurysms, and 23 had ruptured aneurysms. Most of those undergo ing elective operations had an asymptomatic pulsatile mass. In contrast, all those with expanding or ruptured aneurysms had abdominal or back pain, and most of those with ruptured aneurysms were in shock. The mortality rates for the elective, expanding, and ruptured groups were 4.6%, 12.5%, and 60.8% respectively. The most common cause of death in those undergoing elective op eration was myocardial infarction, while the most common cause of death from a ruptured aneurysm was multisystem failure. Improved mortality rates for the second five-year period (1980-1984) were noted and may reflect improved pre operative preparation and postoperative monitoring. It appears that elective aneurysmorrhaphy can be accomplished with relative safety in elderly patients, but that rupture carries high morbidity and mortality.