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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
INTERVENTIONAL VASCULAR PROCEDURES
Italian Journal of Vascular and Endovascular Surgery 2012 March;19(1):21-30
Outcome of septuagenarians and octogenarians after open TAAA repair
Sagban T. A., Kocabas F., Balzer K. M., Duran M., Weis-Müller B. T., Grabitz K., Sandmann W.
Department of Vascular Surgery and Kidney Transplantation, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany
Aim: Advanced age has been reported as a predictor of increased morbidity and mortality in patients who undergo major cardiovascular reconstructive surgery. We evaluated and compared the outcome of patients aged 70 to <79 and 79 years or older after thoracoabdominal aortic aneurysm (TAAA) repair.
Methods: From 01/1998 to 07/2008, 480 patients underwent operation for TAAA. 125 patients were between the ages of 70 and 91 years at time of surgery, and these patients were included in this study. Two groups were build (70≤79 years vs. >79 years) and compared. Risk factors were analyzed for their impact on mortality and morbidity in these elderly patients.
Results: Overall, the 30-day mortality rate was 17% (21/125 pts.), in septuagenarians with 15.7% (17/108 pts.) and in patients older than 79 years at 23.5% (4/17 patients). Six patients (4.8%; 6/125) developed neurologic deficits, none in the group of octogenarians. No single preoperative risk factor was significantly associated with increased mortality or neurologic deficits. A mean 5-year survival rate of 62.9% in the younger and 52.9% in the older group can be reported.
Conclusion: TAAA repair in elderly patients can be undertaken with acceptable mortality and morbidity, provided that patients are selected appropriately.