Surgery for acute type A aortic dissection in octogenarians is justified

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Geriatric Medicine

Background:

• Acute type A aortic dissection carries high mortality, with surgical intervention often avoided in octogenarians due to perceived risks.
• Previous studies have reported high morbidity and mortality rates for elderly patients undergoing aortic dissection repair.

Purpose of the Study:

• To compare clinical outcomes and quality of life between octogenarians and younger patients undergoing surgical repair for acute type A aortic dissection.
• To evaluate the feasibility and effectiveness of surgical intervention in elderly patients (≥80 years) with acute type A aortic dissection.

Main Methods:

• Retrospective analysis of 101 patients with acute type A aortic dissection who underwent surgical repair.
• Comparison of 21 octogenarians with 80 younger patients (age <80 years) using deep hypothermic circulatory arrest.
• Quality of life assessment using the RAND 36-Item Short Form Health Survey Questionnaire during follow-up.

Main Results:

• Octogenarians (average age 85) had similar preoperative characteristics to younger patients (average age 60).
• No hospital deaths or late deaths were observed in the octogenarian group during a mean follow-up of 17 months.
• Octogenarians reported better emotional health scores compared to the younger patient group (P = .04).

Conclusions:

• Surgical repair for acute type A aortic dissection is associated with excellent outcomes in octogenarians.
• Age should not be a barrier to offering surgical intervention for acute type A aortic dissection.
• Octogenarians can achieve favorable surgical results and improved quality of life after aortic dissection repair.