Short and mid-term quality of life and outcomes following endo vascular and open surgical repair of abdominal aortic aneurysms

Abstract

Background: This study aims to evaluate short and mid-term outcomes and quality of life of the patients following endovascular aortic aneurysm repair (EVAR) and open surgical repair of abdominal aortic aneurysms (AAA). Methods: Between January 2007 and October 2011, a random sample of 50 patients who underwent AAA repair in our clinic were included. Twenty-six patients underwent open surgical repair, while 24 patients underwent EVAR. The patients were assessed based on age, early mortality rate, comorbidities, renal and hepatic functions, glucose and hemoglobin values, echocardiographic findings, pulmonary function tests, duration of surgery, loss of blood, requirement of transfusion, duration of mechanical ventilation, the length of stay in the intensive care unit and hospital, computed tomography (CT) findings, and patient-reported Short Form 36 (SF-36) outcomes. Results: All patients underwent surgical intervention under general anesthesia. The mean duration of surgery and anesthesia and estimated blood loss were higher in the open surgery group. There was a statistically significant difference in the 30-day mortality rates between the groups (p<0.01). No 30-day mortality was seen in the EVAR group. Eight patients died following open surgery. The mean length of intensive care unit and hospital stay were significantly shorter in the EVAR group (p<0.01). The pulmonary complication rate was lower in the EVAR group (p<0.05). A higher number of patients undergoing open surgery required blood products during the first 30-day postoperatively compared to those undergoing EVAR (p<0.01). The mean SF-36 scores for EVAR patients at one month were significantly higher than for open surgery patients (p<0.01). Conclusion: The short and mid-term quality of life outcomes were better in patients undergoing EVAR due to AAA. However, age and comorbidities should be considered for tailoring treatment strategies and patient.