Prognose na AAAA.pptx

Prognose na AAAA 28 augustus 2015 Loes Hoogveld, MC Casus A •  Dhr B, 68 jaar •  3/7 AAAA waarvoor EVAR •  Nierinsufficiënt na overstenten nierarterieën wv CVVH •  6/7 Darmischemie op sigmoïdoscopie à NTG SOFA-­‐score: 10 (33-­‐95% mortaliteit) APACHE II: 24 (76.4% mortaliteit) Casus B •  Dhr R, 69 jaar •  23/7 AAAA waarvoor buisprothese, infrarenaal geklemd, langdurig diepe hypotensie •  24/7 Ischemie onderbeen links wv fasciotomie en BBA (27/7) •  Nierfunc`estoornissen waarvoor start CVVH •  25/7 Abdominaal compar`ment syndroom met darmischemie wv hemicolectomie en open buik •  26/7 Ischemie onderbeen rechts wv fasciotomie en BBA (4/8) SOFA-­‐score: 13 (95% mortaliteit) APACHE II: 26 (83.4% mortaliteit) Anatomie vaten Prognose na AAAA Alonso-­‐Pérez M et al. Factors increasing the mortality rate for pa3ents with ruptured abdominal aor3c aneurysms. Ann Vasc Surg. 2001;15(6):601. Prognose na AAAA Cho JS et al. Contemporary results of open repair of ruptured abdominal aortoiliac aneurysms: effect of surgeon volume on mortality. J Vasc Surg. 2008;48(1):10. Prognose na AAAA Kopolovic I et al. Risk factors and outcomes associated with acute kidney injury following ruptured abdominal aor3c aneurysm. BMC Nephrol. 2013 May 1;14:99. Conclusie •  Mortaliteit ~ 50% •  Verslechterend met o.a. •  Nierfunc`estoornissen •  Cardiale ischemie •  Darm ischemie Referen6es Alonso-­‐Pérez M et al. Factors increasing the mortality rate for pa3ents with ruptured abdominal aor3c aneurysms. Ann Vasc Surg. 2001;15(6):601. Cho JS et al. Contemporary results of open repair of ruptured abdominal aortoiliac aneurysms: effect of surgeon volume on mortality. J Vasc Surg. 2008;48(1):10. Kopolovic I et al. Risk factors and outcomes associated with acute kidney injury following ruptured abdominal aor3c aneurysm. BMC Nephrol. 2013 May 1;14:99.