During 12 years, from 1998 to 2010, the author operated 567 cases of big, dissecting aortic aneurysms, retroperitoneal, intrapleural rupture or free rupture at Binh Dan Hospital. In comparison with 396 aortic aneurysms operated on 1984 to 1997, complications and dead were. similar the same. In the 567 patients, the average age was 74, the ratio male/female, 4/1. The author operated traditionally, by laparotomy and using prothese for grafting. On 2006, we performed the stent graft for 5 patients who have had cardiac problems. On 2008, the author performed 2 cases of laparoscopic grafting, unfortunally there was one case died by prothetic infection. Acute complications in general are 31 percent and dead 14.8 percent during 30 days postop (567 cases) in comparison 36 percent and 12 percent in the first series (396 cases) (the follow-up until 1998). In the series of 567 cases, complications and dead of subrenal aneurysms, are 31.31 percent and 14.19 percent
complications and dead of descending aorta, thoracoabdominal and suprarenal aneurysms are 34.09 percent and 14.81 percent. In the follow-up, 487 cases, the complications and recurrences are 6.36 percent, reop 6.16 percent and death rate 4.31 percent in comparison of 396 cases, the death rate is 8.04 percent. In the operated cases in the world, here the complications are less, but the death rate is high. These major complications are severe usually, they must be reoperated. The dead are due to aneurismal rupture that the bleeding is so much causing hemorrhagic shock and trouble of coagulation. The low blood pressure caused multi organ failure and dead. So, for prevention of high death rate, the author should operate patients before aneurismal rupture. The author must decide the diameter of aneurysm apte to operate during consultated patients. When operate the cases of aneurysmal rupture, the blood and the fresh plasma are also pret to transfuse.