Aortic Aneurysm–Surgical Treatment in Apollo Hospitals, Dhaka

Abstract

Objective: In developing country, treatment of aortic aneurysm is costly. Surgical treatment is rather cheaper than stent implantation. Long term outcome is favourable with surgical treatment. Methods: This is a retrograde study, was done in Apollo Hospitals Dhaka from 21st December, 2006 to 12th July 2014. 32 patients were operated. Age range was from 22 to 81 years (mean 55.33), male 28, female 4. Infrarenal aortic aneurysm cases were 20, thoraco abdominal aneurysm cases were 4, dissectingaortic aneurysm cases were 2 (CABG+Bracheocephalic artery reimplantation with 8 mm graft), Descending thoracic aortic aneurysm rupture cases were 2, Descending thoracic aortic aneurysm cases were 2, Descending thoracic aortic aneurysm + Bentall procedures were2. Emergency (37.5%) operations were 12 cases :- 6 cases were infrarenal leaking aneurysm, 2 cases were leaking abdominal aortic aneurysm, 2 cases were dissecting aortic aneurysm, 2 cases were Descending thoracic aortic aneurysm rupture. Results: Overall mortality rate was 15.62% (5 cases). Among emergency cases there were 6.25% (2 cases) death rate, per operative one – Descending thoracic aorta rupture in a 75 years old gentleman. Another lady of 35 years died 3 months later where emergency surgery was done for dissecting aortic aneurysm. In routine cases mortality rate was 9.37% (3 cases) – 1 month later a case of thoraco abdominal aneurysm dieddue to diabetic complication, 1 month later 22 years old gentleman (Descending thoracic aortic aneurysm with Bentall procedure) diedas a complication of tracheostomy (tracheo-innominate artery fistula) - sudden severe bleeding; another death in 46 years old gentleman where graft leakage occurred4 years after abdominal aortic aneurysm repair. Rest of the patients arein continuous follow up with us and are doing well.