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Merlo M., Bitossi G., Carignano G., Leotta L., Ponzio F.
1st Vascular Surgery Unit “S. Giovanni Battista” Hospital, Turin, Italy
Aim. Owing to the increased mean life expectancy of the general population and the gradual diminution of anesthesiological risks, the number of elderly patients (ultraoctogenarians) undergoing aortic vascular surgery for aneurysms, both in election and emergency, increases from year to year.
The aim of this study was to evaluate our surgical results in the light of the international literature in an attempt to justify this type of treatment in this particular age range.
Methods. Over the past 3 years, a total of 66 ultraoctogenarian AAA patients with a mean age of 83.2 years were surgically treated. Forty-three patients (65.2%) were operated electively and 23 (34.8%) underwent emergency surgery following rupture. The mean ages of the 2 groups were respectively 82.8 and 83.6 years.
In the group of patients undergoing elective surgery, endoprosthesis was inserted in 18 cases (41.9%), while the remainder underwent traditional reconstruction.
The results were then compared with the group of patients aged under 80, treated during the same period, both in election and in emergency.
Results. The overall mortality in the group of 66 octogenarians was 15.2%; 3 deaths (7.0%) occurred in election and 7 (30.4%) in emergency surgery. In the group of 530 patients aged under 80, the overall mortality was less than 4%, with 12 out of 470 in election (2.6%) and 9 deaths out of 60 in emergency surgery (15.0%).
Conclusion. A careful evaluation of cardiological and anesthesiological risk, combined with appropriate indications for surgery, means that ultraoctogenarian patients can undergo elective surgery to reduce the risk of AAA rupture in this age range, thereby extending life expectancy.