Abstract
BackgroundThere is controversy regarding surgical indication and surgical procedure of acute type A aortic dissection for the elderly. We examined surgical outcomes for the elderly.MethodsFrom January 2012 to December 2019, 174 patients underwent surgical repair for acute type A aortic dissection. We compared the surgical outcomes between the elderly group (≧80 years old) and the non-elderly group (≦79 years old). Additionally, we compared the surgical treatment group with the conservative treatment group.ResultsThe primary entry was found in the ascending aorta in 51.6% of the elderly group and in 32.8% of the non-elderly group (p= 0.049). In the elderly group, ascending or hemiarch replacement was performed in all cases, while in the non-elderly group, ascending or hemiarch replacement was performed in 57.3% (p<0.001). The hospital mortality was similar in both groups. The 5-year survival rate was 48.4±10.3% in the elderly group and 86.7±2.9% in the non-elderly group (p<0.001). The rates of freedom from aortic event at 5 years was 86.9±8.7% in the elderly group and 86.5±3.9% in the non-elderly group (p=0.771). The 5-year survival rate of conservative treatment group was 19.2±8.0% in the elderly. There was no significant difference from the surgical treatment group (p=0.103).ConclusionsThe surgical approach may not always be the reasonable treatment of choice for the elderly because the significant survival merit was not achieved compared with the conservative approach.
293 * EARLY AND LATE OUTCOME AFTER SURGERY FOR ACUTE TYPE A AORTIC DISSECTION IN THE ELDERLY
