Objective: To evaluate the effect of the anaesthesiological and surgical technique on morbidity and mortality in patients with cardiac limitation sundergoing extensive procedure (repair of abdominal aorta aneurysm). Design: Clinical, retrospective study. Setting: Department of Anaesthesiology and Intensive Care, 1st Department of Surgery, Department of Radiology of Palacky University Faculty Hospital and Medical Faculty, Olomouc. Material and Methods: During eight years period (1997–2003) 225 patients were treated for abdominal aorta aneurysm. 115 patients underwent standard surgery (SUR group), 110 patients were treated with endovascular method (EVT group). From case histories and anaesthesiological records, demographic and perioperative data were recorded. They comprised the type and duration of anaesthesia, haemodynamic parameters (blood pressure, puls rate) and number of blood units transfused. Relevant statistical tests were used to compare the SUR and EVT groups; P < 0.05 was considered significant. Results: The groups did not differ in body weight, procedure duration and sex distribution. EVT group patients presented higher risk. The ASA IV grade being more frequent in this group (P < 0.0001). The SUR group included more ASA II grade patients (P = 0.004). Patients in the EVT group were older (P = 0.018), more often they suffered from ischaemic heart disease (P = 0.0002) and more often underwent myocardial infarction (P < 0.0001) and CABG surgery (P = 0.028). Incidence of diabetes mellitus was higher in the EVT group (P = 0.0007). Surgical treatment (SUR group) was usually performed under general anaesthesia (99.1%), while spinal block was preferably used for the EVT group patients (61%). SUR group patients required haemotherapy more often compared to EVT group (P < 0.0001). There was better haemodynamic stability in the EVT group (P < 0.05). Both morbidity and mortality were significantly lower in the EVT group (P < 0.0001 and P = 0.0096, respectively) and intensive care stay was shorter (2 days) than in the SUR group (5 days). The total hospital stay was shorter in the EVT group (5 days) compared to SUR one (11 days). Conslusion: The high risk patients benefit from EVT, which can be a method of choice for them.

        Key words: abdominal aortic aneurysm – stent-graft – high risk patient