1. Management of acute type A aortic dissection in the elderly: an analysis from IRAD
- Author
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Jonathan M, Hemli, Stevan S, Pupovac, Thomas G, Gleason, Thoralf M, Sundt, Nimesh D, Desai, Davide, Pacini, Maral, Ouzounian, Jehangir J, Appoo, Daniel G, Montgomery, Kim A, Eagle, Takeyoshi, Ota, Marco, Di Eusanio, Anthony L, Estrera, Joseph S, Coselli, Himanshu J, Patel, Santi, Trimarchi, and Derek R, Brinster
- Subjects
Aged, 80 and over ,Pulmonary and Respiratory Medicine ,Age Factors ,General Medicine ,Aortic Dissection ,Postoperative Complications ,Treatment Outcome ,Risk Factors ,Humans ,Surgery ,Hospital Mortality ,Registries ,Cardiology and Cardiovascular Medicine ,Aged ,Retrospective Studies - Abstract
OBJECTIVES We sought to examine management and outcomes of (Stanford) type A aortic dissection (TAAAD) in patients aged >70 years. METHODS All patients with TAAAD enrolled in the International Registry of Acute Aortic Dissection database (1996–2018) were studied (n = 5553). Patients were stratified by age and therapeutic strategy. Outcomes for octogenarians were compared with those for septuagenarians. Variables associated with in-hospital mortality were identified by multivariable logistic regression. RESULTS In-hospital mortality for all patients (all ages) was 19.7% (1167 deaths), 16.1% after surgical intervention vs 52.1% for medical management (P 80 years. Fewer octogenarians underwent surgery versus septuagenarians (68.1% vs 85.9%, P CONCLUSIONS When compared with septuagenarians, a smaller percentage of octogenarians undergo surgical repair for TAAAD, even though postoperative outcomes are similar. Age alone should not preclude consideration for surgery in appropriately selected patients with TAAAD.
- Published
- 2022