Long-term outcome after acute type A aortic dissection: does an age limit still exist?

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Disease Management

Background:

• Acute type A aortic dissection (ATAAD) is a life-threatening condition requiring prompt surgical intervention.
• Patient selection for ATAAD surgery often considers age, potentially excluding older individuals.
• Evaluating outcomes in diverse age groups is crucial for refining surgical guidelines.

Purpose of the Study:

• To analyze surgical outcomes in patients with acute type A aortic dissection (ATAAD).
• To compare long-term survival rates between patients aged 70 and older versus those younger than 70.
• To assess survival differences between males and females undergoing ATAAD surgery.

Main Methods:

• Retrospective analysis of 154 patients who underwent surgery for ATAAD between September 1997 and October 2008.
• Comparison of early and long-term survival, and postoperative complications between age groups (≥70 vs. <70 years).
• Stratification of survival data by sex (male vs. female).

Main Results:

• Overall in-hospital mortality was 17.5%; permanent neurological dysfunction occurred in 6.5% of patients.
• Long-term survival rates at 1, 5, and 10 years were 80%, 68%, and 51% for males, and 84.6%, 72.3%, and 47.5% for females, respectively.
• Five- and 10-year survival rates were significantly lower for patients aged 70 and older (50.8% and 26.1%) compared to those younger than 70 (78.1% and 59.4%).

Conclusions:

• Age should not be an absolute contraindication for surgical intervention in acute type A aortic dissection (ATAAD).
• Biological age and clinical status are critical factors in surgical decision-making for ATAAD.
• Long-term survival outcomes after ATAAD surgery showed no statistically significant difference between males and females.