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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2018 Jan 09

DOI: 10.23736/S0021-9509.18.10344-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Is there an age limit for abdominal aortic aneurysm repair?

Björn SONESSON , Nuno DIAS, Tim RESCH

Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden


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INTRODUCTION: There is an increasing number of elderly in society and some of them may have an abdominal aortic aneurysm (AAA). The prevalence of AAA in octo-and non-agenarians indicates that this number could be substantial. The question is; is there an age limit for repair? This complex question incorporates ethical, political, economic and medical aspects. To answer part of this question a review of the outcome of elective and emergent AAA repair in those over 80 was done.
EVIDENCE ACQUSITION: A litterature research was done in the Pubmed and Embase databases between 2007 and 2017 for either emergent and/or elective repair of AAA in individuals older than 80 years of age.
EVIDENCE SYNTHESIS: 10 of 663 studies were found eligible for the review Elective AAA repair in individuals more than 80 years shows a very varying outcome with 30 day mortality between 0 and 20.1% and 1 year mortality between 7 and 26%. Length of procedure, hospital stay and number of major adverse events are also more in those over 80 years of age. In ruptured AAA 30 day mortality is between 29 and 59% and 1 one year between 45 and 63%. CONCLUSIONS: No definitive answer wheter to perform a repair of AAA in the elderly can be given. The descision has to be individulalized and will also vary depending on ethical, political, economic factors and type of healtcare system the individual lives in.


KEY WORDS: Aortic aneurysm - EVAR - Open aneurysm repair - Octogenarians

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Publication History

Article first published online: January 9, 2018
Manuscript accepted: January 3, 2018
Manuscript received: November 30, 2017

Cite this article as

Sonesson B, Dias N, Resch T. Is there an age limit for abdominal aortic aneurysm repair? J Cardiovasc Surg 2018 Jan 09. DOI: 10.23736/S0021-9509.18.10344-2

Corresponding author e-mail

b.sonesson@gmail.com