Document Detail


Should emergency surgical intervention be performed for an octogenarian with type A acute aortic dissection?
MedLine Citation:
PMID:  18455582     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The number of octogenarians undergoing emergency surgery is increasing and may negate the impact of the beneficial advances. The aim of this study was to review octogenarians with type A acute aortic dissection and assess the prognosis. METHODS: Fifty-eight patients with acute aortic dissection, whose average age was 83.2 years, were divided into 2 groups: Group I comprised 30 patients who underwent emergency surgery, and group II comprised 28 patients who were treated conservatively. We compared the 2 groups in terms of mortality and morbidity. RESULTS: In group I, postoperative hospital mortality was 13.3% (4 patients). In group II, 17 patients (60.7%) died in the hospital. In group I, although emergency aortic replacement was successfully completed, 5 patients became bedridden after surgery and 2 patients died of pneumonia or stroke in the early stages of institutional care. Thirteen patients in group I died of malignancies, abdominal aortic rupture, traffic accident, heart failure, or late-stage senility in later phase. There was no difference in actuarial survivals at 5 years, which were 48.5% in group I and 35.4% in group II. CONCLUSION: Emergency surgery for octogenarians with acute aortic dissection showed acceptable mortality. However, families had to take responsibility for patients who experienced unconsciousness, had dementia, or became bedridden. It is important to have consensus between the family and surgeons about emergency surgical treatment for octogenarians.
Authors:
Mitsumasa Hata; Akira Sezai; Tetsuya Niino; Masataka Yoda; Satoshi Unosawa; Nobuyuki Furukawa; Shunji Osaka; Tomohiko Murakami; Kazutomo Minami
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  135     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1042-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. mihata@med.mihon-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Aneurysm, Dissecting / surgery*
Aortic Aneurysm / surgery*
Blood Vessel Prosthesis Implantation*
Emergencies
Female
Humans
Male
Prognosis
Quality of Life*
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2008 May;135(5):984-5   [PMID:  18455572 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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