The most frequent cause of death after elective repair is myocardial dysfunction, which is usually ischemic in origin. For discussion we will divide complications into acute and long-term considerations. In the acute setting, cardiac morbidity or mortality is a significant complication. As previously mentioned the most frequent cause of death is from myocardial dysfunction. Nonfatal MI is also fairly common, even after elective aortic aneurysm repair.
Hemorrhage is a constant threat, most often form injury to iliac or lumbar veins.
It can be severe and extremely difficult to control. Renal failure or less severe renal dysfunction is another complication that can occur in the acute setting. The most serious gastrointestinal complication is ischemia of the left colon and rectum resulting from intra-operative division of the inferior mesenteric artery. Findings indicative of bowel gangrene and peritonitis demand prompt re-operation. Microembolism can also occur, resulting in small patch areas of ischemia, usually on the plantar aspect of the feet.