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Lee Goldman, MD, Discussant

JAMA. 1998;280:366-372.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR PARKER: Mrs H is a 75-year-old woman weighing the risks and benefits of proceeding with an elective surgical repair of an abdominal aortic aneurysm. She lives in the greater Boston area with her husband and has her health care insurance through Medicare.

Mrs H's physicians have followed the size and extent of her thoracic and abdominal aortic aneurysms carefully for several years. By angiogram, the aneurysm involved the origin of the celiac and superior mesenteric arteries, down to the level of the renal arteries. An arteriogram in 1992 revealed a diameter of the thoracic section at 5 cm to 6 cm. An ultrasound in 1995 showed an increase to 6.5 cm. The abdominal aortic aneurysm was measured at approximately 5 cm. By 1996, a magnetic resonance angiogram estimated the thoracic aneurysm at 9 cm, and a computed tomographic (CT) scan estimated its size at 8. . . [Full Text of this Article]

MRS H: HER UNDERSTANDING AND PERCEPTIONS

MRS T, THE DAUGHTER-IN-LAW: HER UNDERSTANDING AND PERCEPTIONS

DR B: HIS UNDERSTANDING AND PERCEPTIONS

AT THE CROSSROADS: QUESTIONS TO DR GOLDMAN

Natural History of Abdominal Aortic Aneurysms

Surgical Approaches

Cardiac, Pulmonary, and Other Medical Risks of Surgery

Long-term Survival After Abdominal Aortic Aneurysm Surgery

Prognosis Independent of the Aortic Aneurysm

Weighing the Risks and Benefits

Patients' Preferences and Quality-of-Life Considerations

What to Do?

QUESTIONS AND DISCUSSION

Dr Goldman is Julius R. Krevans Distinguished Professor and Chairman, Department of Medicine, and Associate Dean for Clinical Affairs, School of Medicine, University of California, San Francisco.

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A 75-Year-Old Woman With an Abdominal Aortic Aneurysm and Emphysema, 1 Year Later
Parker and Hartman
JAMA 1999;281:744-744.
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