Aortic replacement for abdominal aortic aneurysm in elderly patients

Area of Science:

• Vascular Surgery
• Geriatric Medicine
• Cardiovascular Research

Background:

• Advancements in surgical techniques and perioperative care have improved outcomes for elective aortic replacement.
• This has enabled a more aggressive treatment strategy for abdominal aortic aneurysms (AAA) in elderly populations.

Purpose of the Study:

• To evaluate the safety and efficacy of elective aortic replacement in patients aged 80 and older.
• To compare outcomes in elderly patients undergoing elective versus emergent aortic replacement for AAA.

Main Methods:

• Retrospective review of 116 patients aged 80+ who underwent aortic replacement for AAA.
• Comparison of outcomes (mortality, morbidity) between elective and emergent repair groups in the elderly cohort.
• Comparison with a cohort of 780 patients younger than 80 undergoing aortic replacement.

Main Results:

• Elective aortic replacement in 77 patients (80+) had an operative mortality of 3% (2/77) and 8 complications.
• Emergent aortic replacement in 39 patients (80+) had an operative mortality of 20% (8/39).
• Elective aortic replacement in patients <80 had a similar operative mortality of 2% (622 patients).

Conclusions:

• Elective aortic replacement in patients 80 years and older is associated with low operative mortality and morbidity rates.
• Chronological age alone should not be a contraindication for aortic replacement in patients with AAA.
• These findings support an aggressive approach to treating AAA in the elderly through elective aortic repair.