Management of Non-Infectious Aneurisms of the Sub-Kydney Abdominal Aorta at the CHU/JRA

Abstract

Introduction: The aim of this study was to describe the principle of the management for non-infectious aneurysm of the sub-kidney abdominal aorta at the university teaching hospital/JRA Ampefiloha. Materials and methods: It was a retrospective, descriptive study conducted at cardiovascular surgery department of the university teaching hospital/JRA Ampefiloha, for a period of 14 years old (January 2005 to December 2019), including all patients who had an non-infectious aneurysm of the subrenal abdominal aorta at the CHU/JRA Ampefiloha operated on or not. Results: Sixty-one cases were included, with an mean age of 61.71 years old (from 16 to 82 years old), a male predominance (sex ratio-1.34), high blood pressure, dyslipidemia, active smoking and physical inactivity were the predominant risk factors. The circumstances of discovery were often abdominal pain (52.45%) and a flapping abdominal mass (47.54%). Aortic doppler ultrasound and/or CT angiography allowed the diagnosis and describe the type of aneurysm. Most of them was fusiform in 49 cases (80.32%) and sacciform in 12 cases (19.67%), the majority of which had a diameter of between 50 and 60 mm (36.06%). Thirty-nine patients were operated on (63.93%). Conventional surgery with the flattening of the aneurysm followed by a replacement with a prosthetic graft was our reference technique. Postoperative development was favorable in 82.05% of cases. The mortality rate was 6.56%. Conclusion: The hospital frequency of an abdominal aortic aneurysm was 1.53% at the university teaching hospital/JRA Ampefiloha. Conventional surgery was our reference technique, saving the lives of our patients. Keywords: Aneurysm, subrenal abdominal aorta, surgery, prosthesis.