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Aortic surgery requiring hypothermic circulatory arrest in octogenarians
1Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Summary
Aortic surgery using hypothermic circulatory arrest in octogenarians showed acceptable outcomes, despite common postoperative complications. This study highlights the feasibility of such procedures in elderly patients with aortic aneurysms.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Thoracic Surgery
Background:
- Octogenarians are increasingly referred for aortic surgery requiring hypothermic circulatory arrest due to improved cardiovascular operation outcomes.
- Aortic aneurysms in elderly patients necessitate advanced surgical interventions.
Purpose of the Study:
- To evaluate the clinical outcomes of aortic surgery requiring hypothermic circulatory arrest in octogenarians.
- To assess the safety and efficacy of this procedure in an elderly population.
Main Methods:
- Retrospective chart review of 12 octogenarian patients (median age 83) who underwent aortic surgery requiring hypothermic circulatory arrest between 2000 and 2007.
- Analysis of diagnoses (acute type A aortic dissection, degenerative thoracic aneurysm), surgical approaches (median sternotomy, posterolateral thoracotomy), duration of hypothermic circulatory arrest, and brain protection methods (selective antegrade cerebral perfusion, retrograde cerebral perfusion, arrest alone).
Main Results:
- Hospital mortality rate was 8%.
- Major postoperative complications occurred in 50% of patients, including transient neurologic dysfunction in two patients.
- No stroke was reported in the study cohort.
Conclusions:
- Aortic surgery requiring hypothermic circulatory arrest in octogenarians is associated with acceptable clinical outcomes.
- Despite a high rate of postoperative complications, the procedure demonstrates feasibility in this patient group.
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