Abstract
BackgroundThis study aimed to retrospectively investigate our experience of surgical treatment for acute type A aortic dissection in patients older than 70 years.MethodsFrom September 2005 to January 2012, eleven patients who were older than 70 years underwent surgical treatment for type A aortic dissection at our center and were included in this study. Total arch replacement was performed in three patients, seven patients underwent subtotal arch replacement and one with single-branched stent graft implantation. One patient underwent a valve-sparing (David) procedure while another underwent a concomitant aortic valve replacement (Wheat procedure). One patient required coronary artery bypass grafting. All operations were performed under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion.ResultsThere was one in-hospital death (9.1%) and no operative mortality within 30 days. Cardiopulmonary bypass time, myocardial ischemic time and antegrade cerebral perfusion time accounted for 151.4±33.5 minutes, 68.5±41.4 minutes and 30.3±12.9 minutes, respectively. Overall in-hospital duration, intensive care unit (ICU) time and mean ventilation time were 40.9±40.3 days, 16.5±22.5 days and 90.5±139.4 hours, respectively. New postoperative permanent neurological dysfunction and temporary neurological dysfunction were observed in one patient (9.1%) and in three patients (27.3%), respectively. Mean follow-up was 49.0±19.9 months and nine patients are still alive, one patient died of cancer after 24 months postoperation.ConclusionsSurgical management for acute type A dissection in patients older than 70 years is a safe alternative with acceptable risk of death and the early and late results are satisfactory.
Highlights
This study aimed to retrospectively investigate our experience of surgical treatment for acute type A aortic dissection in patients older than 70 years
Background the outcomes of surgical treatment for acute type A aortic dissection have greatly improved in recent years, it is still associated with high mortality and morbidity [1,2]
Six patients were applied with stented elephant implantation, and one patient with a procedure mimicking the frozen elephant trunk procedure
Summary
This study aimed to retrospectively investigate our experience of surgical treatment for acute type A aortic dissection in patients older than 70 years. The outcomes of surgical treatment for acute type A aortic dissection have greatly improved in recent years, it is still associated with high mortality and morbidity [1,2]. For patients who present with acute uncomplicated type B. As life expectancy has been continuing to increase, there are an increasing number of elderly patients with type A aortic dissection [10]. It is necessary to objectively evaluate the early and late surgical outcomes of acute type A dissection in elderly patients. We retrospectively reviewed our experience with patients older than 70 years undergoing open aortic arch reconstruction for type A aortic dissection
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