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Abdominal aortic aneurysms in octogenarians

H Van Damme1, N Sakalihasan, C Vazquez

  • 1Department of Cardiovascular, CHU Liège, Belgium.

Acta Chirurgica Belgica
|June 6, 1998
PubMed
Summary
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Surgery for abdominal aortic aneurysms (AAA) in octogenarians can be safe and effective. Advanced age alone should not preclude AAA repair, with outcomes depending on patient health and aneurysm status.

Area of Science:

  • Vascular Surgery
  • Geriatric Medicine
  • Aortic Aneurysm Management

Background:

  • Abdominal aortic aneurysms (AAA) pose a significant risk in the elderly.
  • Decisions regarding AAA surgery in octogenarians involve balancing operative risks against natural disease progression.

Purpose of the Study:

  • To evaluate the outcomes of abdominal aortic aneurysm (AAA) repair in patients aged 80 years and older.
  • To determine if advanced age alone is a contraindication for AAA surgery.

Main Methods:

  • Retrospective analysis of 138 patients aged 80+ with infrarenal abdominal aortic aneurysms (AAA) from 1984-1996.
  • Categorization of AAA based on symptoms (asymptomatic, painful, ruptured) and management (immediate/delayed elective, urgent, emergent).
  • Comparison of survival rates between operated and non-operated patients, and with the general population.

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Main Results:

  • In-hospital mortality for elective AAA repair was 5.7%, 28% for urgent, and 68% for emergent surgery.
  • Five-year survival rates were 47% (elective), 30% (urgent), and 20% (emergent), compared to 63% in the general population.
  • Of initially non-operated asymptomatic AAA patients, 33% experienced rupture, with 13 requiring emergency surgery.

Conclusions:

  • Abdominal aortic aneurysm (AAA) surgery should not be denied to octogenarians solely based on age.
  • Recommendations include straightforward surgery for healthy octogenarians with AAA ≥50 mm, surveillance up to 60 mm for high-risk patients, and no surgery for unfit individuals.