Vietnam: Man Saved From Ruptured Abdominal Aortic Aneurysm After 4-Hour Surgery

Ho Chi Minh City, Vietnam – A 67-year-old man has been saved from a life-threatening abdominal aortic aneurysm that was on the verge of rupture, following a complex nearly four-hour open surgery at Gia Dinh People's Hospital in southern Vietnam. The patient initially sought medical attention for persistent abdominal discomfort and bloating, which he mistook for digestive issues. Diagnostic imaging revealed a large abdominal aortic aneurysm in the infrarenal segment, with multiple dilatations posing an imminent rupture risk. The patient presented with a challenging medical profile, including over 50% carotid artery stenosis (a risk factor for stroke due to blood pressure fluctuations), chronic obstructive pulmonary disease (COPD) leading to reduced respiratory function, and stage 4 chronic kidney disease, bordering on the need for dialysis. His condition made him highly sensitive to contrast agents and susceptible to ischemia during surgery. Endovascular aneurysm repair (EVAR) with stent grafts was initially considered. However, the patient's severely calcified, narrowed, and tortuous vascular system rendered it impossible to deliver the necessary devices to the lesion site. Consequently, the surgical team opted for open surgery to resect the aneurysmal segment and replace it with a synthetic graft. Associate Professor Dr. Tran Minh Bao Luan, Deputy Head of the Thoracic and Vascular Surgery Department, highlighted the extreme difficulty in controlling and suturing the blood vessels in the infrarenal area. The atherosclerotic, fragile vessel walls were prone to tearing, with even minor deviations potentially leading to uncontrollable bleeding. The surgical team meticulously ensured each stitch was precise and maintained hemodynamic stability throughout the procedure. After nearly four hours, the surgical team successfully removed the aneurysm and re-established blood flow through the artificial graft. The circulation in the patient's lower extremities recovered well, with no reported bleeding complications. Following intensive post-operative care, the patient has since recovered and been discharged. Doctors emphasize that abdominal aortic aneurysms often develop silently in their early stages, typically discovered incidentally during health check-ups or ultrasounds. Their danger lies in the potential for massive blood loss upon rupture, leading to a very high mortality rate if not surgically treated promptly. The medical professionals strongly recommend that individuals over 50, particularly those with hypertension, dyslipidemia, atherosclerosis, or a long history of smoking, undergo regular abdominal ultrasound screenings every 6-12 months for early detection. Warning signs include dull abdominal or back pain and a pulsating sensation in the abdomen. Sudden, severe abdominal pain accompanied by dizziness and cold sweats can indicate a rupture and requires immediate emergency medical attention. Beyond screening, doctors advise maintaining a healthy lifestyle, controlling blood pressure and blood sugar, limiting smoking, and adopting a diet low in salt and saturated fats to protect vascular health.