[Surgery of abdominal aortic aneurysms in octogenarians. Critical remarks on indications for surgical intervention in...

Following the increased frequency of surgery for aortic abdominal aneurysm, due to increasing population age and to improved surgical and anaesthesiological techniques, results in octogenarians are presented and compared. The analysed data derive from 809 consecutive patients operated between January 1987 and December 1993. These have been divided into three age groups: group A = under 65 years, group B = from 65 to 79, group C = from 80 to 93. For each group surgery has been divided in planned operations (symptomatic and asymptomatic cases) and emergency operations (performed after aneurysm rupture) and results are compared. Surgery has been performed as an emergency in 8.6% of cases of group A, in 18.4% of group B and in 41.3% of cases of group C. Death rate in the three groups was respectively of 1.78%, 1.90% and 4.68% for planned operations and 12.50%, 32.63% and 46.67% for the emergency operations. These data confirm the experience of other Authors and indicate that age factor must not be considered a controindication for planned surgery. The importance of this factor in emergency surgery, the greater frequency of ruptures with increased age and the quality of the results in planned surgery suggest a widening of the indications for surgery: the aneurysm transverse diameter of 5 cm, as a minimal measure for planned surgery, must be reconsidered.