Outcomes of limited proximal aortic replacement for type A aortic dissection in octogenarians

Kondoh, Haruhiko; Satoh, Hisashi; Daimon, Takashi; Tauchi, Yuuya; Yamamoto, Jumpei; Abe, Kazuo; Matsuda, Hikaru

doi:10.1016/j.jtcvs.2016.03.093

Cited by 24 publications

(23 citation statements)

References 18 publications

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“…In addition, the favorable long term survival indicated that the simple or less extensive arch repair is the preferred surgery for patients over 70 years old. This nding is also corroborated by other studies [2][18].…”

Section: Discussionsupporting

confidence: 91%

The Impact of Age in Acute Type A Aortic Dissection: a Retrospective Study

Wang

Xue

Zhu

et al. 2021

Preprint

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Background: Acute type A aortic dissection (aTAAD) is a lethal disease and age is an important risk factor for outcomes. This retrospective study was to analyze the impact of age stratification in aTAAD, and to provide clues for surgeons when they make choices of therapy strategies. Methods: From January 2011 to December 2019, 1092 aTAAD patients from Nanjing Drum Tower Hospital received surgical therapy. Patients were divided into 7 groups according to every ten-year interval (20s-80s). The differences between the groups were analyzed in terms of the baseline preoperative conditions, surgical methods and postoperative outcomes of patients of different age groups. During a median follow-up term of 17 months, the survival rates were compared among 7 groups through Kaplan-Meier analysis.Results: The median age was 52.0 years old in whole cohort. The multiple comorbidities were more common in old age groups (60s, 70s, 80s), while the 20s group patients had the highest proportion of Marfan syndrome (28.1%). Preoperative hypotension was highest in 80s (16.7%, P=0.038). Young age groups (20s-60s) had a higher rate of root replacement and total arch replacement, which led to a longer duration of operation and hypothermic circulation arrest. The overall mortality was 14.1%, the tendency of mortality was increased with age except 20s group (33.3% in 80s, P=0.016). The postoperative morbidity of gastrointestinal bleeding and bowel ischemia were 16.7% and 11.1% in 80s group. Conclusions: Age is a major impact factor for aTAAD surgery. Old patients presented more comorbidities before surgery, the mortality and complications rate were significantly higher even with less invasive and conservative surgical therapy. But the favorable long term survival indicated that the simple or less extensive arch repair is the preferred surgery for patients over 70 years old.

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Section: Discussionsupporting

confidence: 91%

The Impact of Age in Acute Type A Aortic Dissection: a Retrospective Study

Wang

Xue

Zhu

et al. 2021

Preprint

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“…Preoperative clinical severity, such as shock status, cardiopulmonary resuscitation, or malperfusion syndrome, deeply affects morbidity and mortality after surgical treatment of ATAAD [22]. Patients in the frail group were older and more likely to be female.…”

Section: Commentmentioning

confidence: 99%

Impact of Frailty on Outcomes in Acute Type A Aortic Dissection

Gomibuchi

Seto

Komatsu

et al. 2018

The Annals of Thoracic Surgery

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“…Theoretically, the complexity of the intraoperative procedure could be associated with a longer aortic cross-clamp time [2,15]. Although the extent of aortic replacement procedures were not different between the ECMO and non-ECMO groups in this study, the selection of extended aortic procedures must still be carefully considered in aTAAD patients with preoperative hemodynamic instability [19][20][21]. However, procedure selection should still adhere to the principle of exclusion of the intimal tear in the dissected aorta [2].…”

Section: Commentmentioning

confidence: 99%