From May 1981 through April 1996, 19 patients with ruptured abdominal aortic aneurysm were admitted to our department. There were 18 men and 1 woman with a mean age of 69 years. Fifteen cases were in shock with a systolic blood pressure<80mmHg and 4 cases required chest compression for hypotension. One patient died of cardiac arrest on the operating table, 3 died of multiple organ failure or respiratory failure in hospital. The overall mortality rate was 21%. The mortality rate of patients under the age of 70 years was 10%, whereas that for those over 70 years of age was 33%. We believe that the use of intraoperative ileal tubing and postoperative continuous hemofiltration would improve the mortality rate in cases of ruptured abdominal aortic aneurysms.

The purpose of this study was to determine the effect of intraoperative autologous blood salvage during elective abdominal aortic aneurysm repair with Cell Saver 4 (Heamonetics Inc.). Fifty patients prospectively received intraoperative autologous transfusion (Group CS; n=50, 1991-94) and 25 received no intraoperative autologous transfusion (Group NCS; n=25, 1983-91). Only 7 patients in Group NCS received no homologous blood (28%), while 43 in Group CS received autologous blood transfusion (86%). There was no difference between the groups with respect to postoperative platelets counts or serum concentrations of total protein, albumin, BUN and LDH. We conclude that the use of the Cell Saver 4 reduces perioperative homologous blood during elective aortic aneurysm repair.