Related Experiment Video
Updated: Jun 24, 2026
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Should octogenarians be denied access to surgery for acute type A aortic dissection?
A Piccardo1, T Regesta, S Pansini
1Division of Cardiac Surgery, San Martino University Hospital, Genoa, Italy. alessandropiccardo@gmail.com
The Journal of Cardiovascular Surgery
|March 31, 2009
Summary
Surgery for acute type A aortic dissection in octogenarians has high hospital mortality but good long-term survival for survivors. A less aggressive surgical approach may improve outcomes for these high-risk patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Outcomes for octogenarians undergoing surgery for acute type A aortic dissection are debated.
- This study analyzes surgical outcomes in patients aged 80 and older.
Purpose of the Study:
- To evaluate the outcomes of emergency surgery for acute type A aortic dissection in octogenarians.
- To identify factors influencing mortality and complications in this high-risk group.
- To suggest strategies for improving surgical results in elderly patients.
Main Methods:
- Retrospective review of 319 patients undergoing emergency surgery for acute type A aortic dissection.
- Focus on 23 patients aged 80 years or older.
- Data collected included preoperative conditions, surgical procedures (ascending aorta replacement, root/arch replacement), and follow-up.
Main Results:
- Hospital mortality was high at 61% (14/23 patients).
- Overall survival was 39% at 1 year and 33% at 5 years.
- Extension of surgery to the aortic arch was an independent risk factor for hospital death.
Conclusions:
- Surgery for acute type A aortic dissection in octogenarians is associated with high hospital mortality.
- Discharged patients demonstrate satisfactory long-term survival.
- A less aggressive surgical strategy may enhance outcomes in this population.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...