Abstract
Ruptured abdominal aortic aneurysm (RAAA) is a condition with a high fatality rate, which requires emergency surgery. In cases where circulatory dynamics fail, the only way to ensure survival is to cross-clamp the aorta swiftly at the proximal aorta of the ruptured site. At our hospital, we have experienced three RAAA cases transferred from a remote island under cross-clamping the aorta. One case was a 68-year-old man. He was diagnosed with RAAA at a previous hospital and experienced acrotism while waiting to be transferred, at which point emergency cross-clamping of the aorta was administered and he was transported under emergency conditions. He survived as a result of emergency surgery. The second was a 58-year-old man. Similar to the first case, he was diagnosed with RAAA, and his symptoms had deteriorated suddenly while waiting for transfer, and therefore emergency cross-clamping of the aorta was performed and he was transported here under emergency conditions. He survived as a result of emergency surgery. The third case was a 70-year-old man. Subsequent to being diagnosed as RAAA, cross-clamping of the aorta was performed due to sudden deterioration of his symptoms, but the patient was unable to recover from a state of shock. When he was transferred to this hospital, his blood pressure was unmeasurable, and despite being subjected to further cross-clamping and continued cardio-pulmonary resuscitation in the operating theater, he did not survive. Our experiences suggest that in cases of RAAA in which shock is present, implementing aortic cross-clamping below the renal artery bifurcation before transferring the patient to a facility that offers surgery is effective.
