AAA Surgical Repair
Zipes, Douglas, The Saturday Evening Post
Reader: I have received conflicting advice about when an abdominal aortic aneurysm (AAA) requires surgical repair. My AAA is 4.8 cm. Is the operation so serious that the chances of survival are poor? I was told that I probably couldn't survive it.
Dr. Zipes: You are correct in noting that size is the major issue in determining whether an abdominal aortic aneurysm will rupture and when surgery should be done to avoid that risk. Aneurysms smaller than 4.0 to 4.9 cm have a 1.5 percent annual rupture risk, and for those 5.0 to 5.9, the risk is 6.5 percent. For aneurysms greater than 6.0 cm, the annual risk of rupture rises sharply. Other important determinants are rapidity of size increase and whether abdominal pain is present.
Generally, surgery is not indicated for aneurysms less than 5.5 cm in size, and patients are followed at least every six months. However, you may be hearing conflicting advice because rupture occurs three times more often in women than men and at a smaller aortic diameter (mean diameter of 5. …