Surgical outcomes of acute type A aortic dissection in septuagenarians and octogenarians. (September 2022)

• Record Type: Journal Article
• Authors: Nakai, Yosuke; Yamada, Toshiyuki; Ogawa, Shinji; Kamiya, Shinji; Saitoh, Yuhei; Suda, Hisao
• Is Part Of: Asian cardiovascular & thoracic annals. Volume 30:Number 7(2022)
• Page Start: 772
• Page End: 778
• Publication Date: 2022-09
• Subjects: Aortic disease -- acute aortic dissection -- aortic operation -- outcome -- octogenarian; Heart -- Diseases -- Asia -- Periodicals; Heart -- Diseases -- Pacific Area -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Surgery -- Asia -- Periodicals; Heart -- Surgery -- Pacific Area -- Periodicals; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Asia -- Periodicals; Chest -- Surgery -- Pacific Area -- Periodicals; Chest -- Surgery -- Periodicals; 617.412
• DOI: 10.1177/02184923221083369
• Languages: English
• ISSNs: 0218-4923

Abstract

Background: We studied surgical outcomes of acute type A aortic dissection and compared early and late outcomes between septuagenarians and octogenarians. Methods: From 2010 to 2019, we evaluated 254 consecutive patients with acute type A aortic dissection. We performed emergent operations within 48 h of symptom onset for 188 patients, including 59 septuagenarians and 32 octogenarians. Results: The overall 30-day mortality rate was 8.5% in septuagenarians and 9.4% in octogenarians ( p = 1.0). The hospital mortality rate was 10.2% in septuagenarians and 12.5% in octogenarians ( p = 0.74). Multivariate analysis identified prolonged ventilation (≥ 72 h) as a significant risk factor for hospital mortality. Being an octogenarian was not significantly associated with hospital mortality. The actuarial survival rate at 5 years was 80.1% in septuagenarians and 58.5% in octogenarians (log-rank p = 0.09). The freedom from aortic event rate at 5 years was 91.0% in septuagenarians and 100% in octogenarians (log-rank p = 0.23). Conclusion: The two groups showed no significant differences in hospital mortality or morbidity. Our tear-oriented strategies might be appropriate for both septuagenarians and octogenarians. Prolonged ventilation (≥ 72 h) was a significant risk predictor for hospital mortality.