On January 24, our interventional vascular surgery department performed aneurysm resection and abdominal aortic prosthetic vessel replacement for a patient with a ruptured abdominal aortic aneurysm, saving this patient from the brink of death who was in a critical and life-threatening condition. Abdominal aortic aneurysm, with the word “aneurysm” in its name, is not the kind of tumor that grows on the liver or in the brain that we usually refer to. The abdominal aortic aneurysm is not a tumor that grows on the abdominal aorta, but rather the wall of the abdominal aorta is damaged by certain pathological factors, and the high speed and high pressure blood flow causes it to expand and expand to a certain extent and then the wall of the vessel becomes thin. At this time, this small section of the abdominal aorta is like a balloon that has been blown up, or, to use another analogy, like a bicycle tire that is bulging. The balloon will blow up, the tire will burst, and the abdominal aortic aneurysm will continue to expand and expand, and will eventually rupture and cause bleeding. It can be said that an unruptured abdominal aortic aneurysm is simply an invisible “untimely bomb” in the stomach! Because the abdominal aorta is one of the main blood vessels in the human body, once the abdominal aortic aneurysm ruptures, blood will instantly spurt into the abdominal cavity, blood pressure will plummet, and the blood supply to the heart and brain will be insufficient, which will be fatal in a few minutes, figuratively speaking, it is an “untimely bomb” that explodes and burns, and the patient’s life is in danger at any time! The famous scientist Albert Einstein died because of ruptured abdominal aortic aneurysm; China’s famous scientist Li Siguang also died because of ruptured abdominal aortic aneurysm. Even though medicine is so advanced today, 50% of patients with ruptured abdominal aortic aneurysms will die before they can be seen, and 80% of those who can make it to the hospital will die despite active treatment, so it can be said that the degree of danger exceeds that of acute heart attack and brain hemorrhage. Therefore, although abdominal aortic aneurysms are not malignant tumors, they are more frightening than malignant tumors! Master Tang, 66 years old, had fever for three days in a row with temperature up to 40℃. He visited fever clinics in several hospitals, and doctors considered it as possible bacteraemia and sepsis and gave anti-infection treatment, but the fever never subsided and was accompanied by severe back pain. The local hospital doctors in Tangshan gave moncler outlet online a CT examination of the abdominal organs and found that the contrast agent had leaked into the abdominal cavity and the blood vessel had ruptured. The local hospital immediately contacted the chief physician of our interventional vascular surgery department, Dr. Zhang Xiansheng, and found that Master Li’s abdominal aortic aneurysm had reached a diameter of nearly 8 cm, and the aneurysm had ruptured and the bleeding was wrapped by the retroperitoneal tissue and accompanied by a serious infection. A small change in blood pressure and abdominal pressure could take the patient’s life. After the diagnosis was clear, the surgical team of Dr. Xiansheng Zhang, chief surgeon of our interventional vascular surgery department, immediately began to discuss the plan for surgical repair of the ruptured tumor and the postoperative treatment plan. Conventional stenting surgery is risky, and although it can seal the leak, the infected hematoma around the rupture is not removed, which can cause stent infection and lead to catastrophic consequences. If the surgeon, anesthesiologist, and surgical nurse cannot cooperate seamlessly and complete the surgery quickly and skillfully, even a small mistake may affect the life of Mr. Tang; moreover, post-surgical complications such as cardiovascular events, respiratory failure, renal failure, irreversible shock, liver failure, or multiple organ failure are very likely. The possibility of postoperative monitoring, rehydration, and supportive therapy is also critical. Previous experience shows that 42% of patients may have postoperative cardiovascular events, such as cardiac arrest (20-28%), myocardial infarction, arrhythmia, and congestive heart failure, with a total morbidity and mortality rate of 44% or more, mostly due to hypotension and increased cardiac load due to aortic block; the incidence of respiratory failure is 26-47%, with an associated morbidity and mortality rate of 34-68%, mostly due to primary pulmonary disease, and The incidence of renal failure (26-42%) can be 76-89%. The risks and difficulties were undoubtedly enormous, but in front of the patient’s life, Zhang Xiansheng did not hesitate to rise to the challenge and decided to perform abdominal aortic prosthetic vessel replacement. After careful preoperative preparations, on June 24, Zhang Xiansheng, Yin Jie, Success and other physicians performed the surgery for Master Tang. The procedure was undoubtedly a “race to the death”. The conventional open excision of abdominal aortic aneurysm can clearly free the lumbar artery to reveal and ligate comfortably to stop the bleeding. However, the doctors found that the inflammatory edema and severe adhesions around the ruptured aneurysm in the abdominal cavity of Master Tang made it impossible to reveal the anatomy from the retroperitoneum and below the duodenum, and a slight separation during the operation would cause extensive diffuse bleeding from the wound. The surgeons decisively decided to block the abdominal aorta below the renal artery and also block the bilateral iliac arteries, and cut the surface of the abdominal aortic aneurysm under direct vision, which was equivalent to controlling the amount of “explosives” and then actively detonating the “bomb”. While calmly suturing and stopping the bleeding, the doctors quickly removed the hematoma and plaque from the aneurysm. The Y-shaped artificial blood vessel was then delicately anastomosed to each blood vessel. At the operating table, Dr. Li Chunqing of the Department of Anesthesiology closely observed the surgical process and administered drugs precisely to maintain blood pressure as the blood vessels were opened and blocked. With the unfailing cooperation of the medical staff, the operation was successfully completed. Master Tang’s vital signs were stable and he returned to the ward safely. The old man is grateful: “You took the risk of discharging the ‘bomb’ in my body and saved my life! Our family thanks you and Peking University First Hospital!”