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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Thoracoabdominal aortic replacement in the elderly: a retrospective propensity score-matched outcome analysis
Florian Helms1, Heike Krüger1, Ezin Deniz1
1Division for Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Annals of Medicine and Surgery (2012)
|July 11, 2026
Summary
Elderly patients undergoing thoracoabdominal aortic repair face longer intensive care unit stays and more postoperative complications, but short-term mortality remains similar to younger patients. Age should not be an exclusion criterion, but careful evaluation is needed.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Vascular Surgery
Background:
- The aging global population is increasing the demand for thoracoabdominal aortic repair.
- Data on outcomes for elderly patients undergoing this procedure is limited.
- Surgeons face challenges in determining the appropriateness of this invasive surgery for older adults.
Purpose of the Study:
- To analyze the outcomes of open surgical thoracoabdominal aortic repair in patients aged 70 years and older compared to younger patients.
- To identify specific postoperative complications and mortality rates in elderly patients.
- To provide evidence-based guidance on the suitability of this procedure for the elderly population.
Main Methods:
- A propensity score-matched, single-center analysis of 309 consecutive patients undergoing open surgical thoracoabdominal aortic repair (2000-2024).
- Comparison of 68 matched pairs of patients aged 70 years or older versus those younger than 70.
- Analysis of intraoperative characteristics, postoperative events, complications, and mortality.
Main Results:
- Elderly patients (≥70 years) experienced significantly longer intensive care unit (ICU) stays (6 vs. 3 days).
- Higher rates of postoperative complications were observed in elderly patients, including respiratory failure (47.1% vs. 25.0%), acute kidney failure (30.9% vs. 14.7%), and new-onset atrial fibrillation (14.7% vs. 4.4%).
- Thirty-day mortality did not significantly differ between the elderly and younger groups (17.6% vs. 13.2%).
Conclusions:
- Elderly patients are more susceptible to prolonged and complicated postoperative courses after thoracoabdominal aortic repair.
- Despite increased complications, short-term mortality is not excessively higher in the elderly population.
- Age alone should not preclude patients from undergoing thoracoabdominal aortic repair, but critical evaluation and preparation for extended ICU stays are essential.
