A chronic contained rupture of an infrarenal abdominal aortic aneurysm eroded a lumbar vertebra. A 53-year-old man complained of severe back pain for 6 months. Recently the back pain had increased. The patient looked well but a pulsatile mass in the abdomen was palpable. A CT and MRI of the abdomen and lumbar spine revealed the infrarenal abdominal aneurysm which demonstrated destruction of the third and fourth lumbar vertebra. At operation, there was a true aneurysm of the native aorta with a rupture of the posterior wall, resulting in a retroperitoneal hematoma. An orifice of the ruptured pseudoaneurysma was 2×2cm in size. An aortobiiliac graft was implanted. The patient did well postoperatively and was discharged on the 32nd postoperative day.

We investigated the quality of life (QOL) after thoracic or thoraco-abdominal aneurysmectomy in patients who had undergone the procedure within the past 15 years. We compared preoperative to postoperative performance status (PS). Defining PS in the following manner: one increase in that PS grade indicated mild worsening while an increase is by 2 or more indicated severe worsening. Maintenance was indicated by no change of PS after surgery. The QOL maintenance rate was calculated based on the following formula.
QOL maintenance(%)=No. of no change case/No. of operated cases-No. of death×100
There were a total of 74 cases in whom follow-ups could be carried out after surgery. Among them, there were ascending and aortic arch aneurysms in 19 cases, descending aortic aneurysms in 20 cases, dissecting aneurysms in 27 cases and thoraco-abdominal aortic aneurysms in 8 cases. The QOL maintenance rate in the type B dissecting aneurysms was comparatively high (85.7%). There were cases of severe worsening of PS in the ascending and aortic arch aneurysms and type A dissecting aneurysms and the QOL maintenance rate was 50% in each other. We should obtain high operative results due to improve the QOL maintenance rate, and devise the operative procedure without functional disorders of the organs after surgery.