Yetmiþ yaþ üstü hastalarda uygulanan tip-A aortik diseksiyonlarýnda cerrahi yaklaþým

Surgical approach for the septagenerian patients with type A aortic

BACKGROUND: We analysed early and late results of type A aortic dissection in patients over 70 years of age. METHODS: Sixteen patients over 70 years of age, operated for type A aortic dissections were analysed retrospectively. The mean age of the patients were 72.1±1.6 years. Five patients were operated on emergent basis for acute and 11 in elective conditions. Deep hypothermic circulatory support was used in 4 patients. Retrograd cerebroplegia was used in 7 cases. The mean duration of follow-up was 33.2±43.5 months. RESULTS: The rate of early mortality was 18.8% (n=3) due to multiorgan failure. In 4 cases, excess drainage from the chest tubes were noted, and one patient required reoperation for bleeding. Two patients had neurological complications. In 2 patients with acute dissections, low cardiac output syndrome developed. Although they didn’t have coronary artery disease, hemodynamic improvement was noted with inotropes.One patient with acute aortic dissection had renal failure postoperatively. Two patients, one of whom with a history of chronic obstructive pulmonary disease, had respiratory problems postoperatively. CONCLUSION: High variability in mortality rates indicates that advanced age, solely is not an independent predictor of death. Assuming age as a complementary factor defining patient’s clinical status will be helpful for more accurate clinical judgement.