Early complications in patients undergoing elective open surgery for infrarenal aortic aneurysms

Abstract

Objective: To assess the type and frequency of early postoperative complications in patients after open surgical infrarenal aneurysms repair and determination of their risk factors. Study Design: An observational study Place and Duration of Study: The 4th Military Teaching Hospital in Wroclaw, Poland, from January 2012 to December 2016. Methodology: Analyses of medical records of 205 patients treated for infrarenal aneurysm with open surgery. Patients with clinical and radiological features of aneurysm rupture were excluded. Complications and early deaths (<30 days) were recorded. Results: Men represented 170 (83%) of patients, the average age was 67.9 ±6.68 years. Aneurysm diameter <60 mm occurred in 107 (52.2%) of patients, 60-80 mm in 76 (37.1%), and >80 mm in 22 (10.7%). Aortic prostheses (tube grafts) were implanted in 132 (64.4%) of patients and aorto-bifemoral (bifurcated) grafts in 73 (35.6%). The most common postoperative complications were: reoperation necessity (n=23; 11.2%), respiratory failure (n=21; 10.2%), respiratory tract infection (n=14; 6.8%), circulatory failure (n=14; 6.8%), lower limb ischemia (n=13; 6.3%), kidney failure (n=12; 5.9%), death (n=9; 4.4%), and surgical wound infection (n=9; 4.4%). Statistical analysis indicated intraoperative blood loss, duration of surgery, a larger aneurysm diameter, and diabetes as risk factors for early complications. Conclusion: Complications were the same as reported from other centres. There is a need to shorten surgery duration and minimise blood loss, as these modifiable factors were the predictors of early complications.