Original articleAdult cardiacOctogenarians With Uncomplicated Acute Type A Aortic Dissection Benefit From Emergency Operation
Section snippets
Registry of Octogenarian Patients Operated on for Acute Type A Aortic Dissection
This registry aims to assess the risk factors for in-hospital mortality, the incidence of postoperative complications, and the outcomes in octogenarian patients operated on for aTAAD. Quality of life was not investigated. (Appendix).
Acute type A aortic dissection was defined as involvement of the ascending aorta presenting within 14 days of the onset of symptoms. Beginning January 1, 2000, all patients who were operated on for aTAAD at the participating centers and were 80 or more years old
Study Population
During the study period, 654 patients underwent operations for aTAAD at the participating centers. Among these, 79 (12.1%) patients were octogenarians and were enrolled in the registry (Table 1). The mean age was 81.6 ± 2 years (range. 80–89 years); 9 patients (11.4%) were aged 85 years or more. The majority of patients had a history of hypertension (72.1%). Coronary artery disease (13.9%) was frequent. Four patients (5%) had a history of previous aortic valve replacement.
The clinical
Comment
The question whether surgical therapy should be proposed to patients needs to be guided by the capacity of that approach to reverse the bad prognosis of the disease. Information about the survival of medically treated patients with aTAAD is sparse. The International Registry of Acute Aortic Dissection investigation reported an in-hospital mortality rate of 45% to 62% in octogenarians denied surgical intervention because of their advanced age or comorbidity [7].
The published survival among
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