[Surgical Strategy for Aortic Arch Aneurysms in Octogenarians]

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Geriatric Medicine

Background:

• Atherosclerotic aortic arch aneurysms pose significant risks, especially in octogenarians.
• Surgical options include open aortic arch surgery and debranching thoracic endovascular aortic repair (TEVAR).

Purpose of the Study:

• To compare the short- and mid-term outcomes of open aortic arch surgery versus debranching TEVAR in octogenarian patients.
• To evaluate the safety and efficacy of these procedures in an elderly population.

Main Methods:

• A retrospective study of 26 octogenarian patients with atherosclerotic aortic arch aneurysms from 2011-2019.
• Group O: 10 patients underwent open aortic arch surgery.
• Group D: 16 patients underwent debranching TEVAR.

Main Results:

• No operative deaths occurred in either group.
• Group D (debranching TEVAR) showed significantly shorter hospitalization (12 days vs. 49 days) and ICU stays (2 days vs. 13 days) compared to Group O.
• Mid-term survival rates favored debranching TEVAR, with lower mortality at 24, 36, and 48 months.

Conclusions:

• Both open aortic arch surgery and debranching TEVAR demonstrate acceptable outcomes in octogenarians.
• Debranching TEVAR is a feasible alternative due to its early postoperative recovery benefits.
• This suggests a shift towards less invasive options for complex aortic arch pathology in the elderly.