Year: 2024
Type: article
Abstract: Objective: To evaluate the benefits of surgical repair acute type A aortic dissection (ATAAD) on survival of octogenarians. Methods: Patients who underwent surgery for acute ATAAD from the multicenter European Registry of Type A Aortic Dissection (ERTAAD) were the subjects of the present analysis. Results: < 0.001). The hazard of mortality was higher among octogenarians up to two years after surgery, but it became comparable to that of younger patients up to 5 years. Among patients who survived 3 months after surgery, 10-year relative survival was 0.77 in patients aged < 80 years, and 0.46 in patients aged ≥ 80 years. Relative survival of octogenarians decreased markedly 5 years after surgery. Age ≥ 85 years, glomerular filtration rate, preoperative invasive ventilation, preoperative mesenteric mal-perfusion and aortic root replacement were independent predictors of in-hospital mortality among octogenarians (AUC = 0.792; E:O ratio = 0.991; CITL = 0.016; slope = 1.096). An additive score was developed. A risk score ≤ 1 was observed in 68.4% of patients, and their in-hospital mortality was 20.9%. Conclusions: Provided a thoughtful patient selection, surgery may provide a survival benefit in patients aged ≥ 80 years with ATAAD that, when compared to younger patients and the general population, may last up to 5 years after the procedure. These findings have significant epidemiologic and clinical relevance because of the increasing longevity of the population of the Western countries.
Source: 老年心脏病学杂志：英文版
Authors: Antonio Fiore, Javier Rodriguez Lega, Joscha Buech, Giovanni Mariscalco, Andrea Perrotti, Konrad Wisniewski, Angel G. Pinto, Till Demal, Jan Rocek, Petr Kacer, Giuseppe Gatti, Igor Vendramin, Mauro Rinaldi, Eduard Quintana, Dario Di Perna, Francesco Nappi, Mark Field, Amer Harky, Matteo Pettinari, Angelo M. Dell’Aquila, Francesco Onorati, Mikko Jormalainen, Tatu Juvonen, Timo Mäkikallio, Caroline Radner, Sven Peterss, Vito D’Andrea, Fausto Biancari
Institutions: Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Hospital General Universitario Gregorio Marañón, LMU Klinikum, German Centre for Cardiovascular Research, Ludwig-Maximilians-Universität München, Glenfield Hospital, Université de Franche-Comté, University Hospital Münster, Universität Hamburg, Charles University, University Hospital Kralovske Vinohrady, Azienda sanitaria universitaria Giuliano Isontina, University of Udine, University of Turin, Hospital Clínic de Barcelona, Universitat de Barcelona, Centre Hospitalier Annecy Genevois, Centre Cardiologique du Nord, Liverpool Heart and Chest Hospital, Cliniques Universitaires Saint-Luc, Ziekenhuis Oost-Limburg, Martin Luther University Halle-Wittenberg, University of Verona, University of Oulu, University of Helsinki, Helsinki University Hospital, South Karelia Central Hospital, Sapienza University of Rome, Centro Cardiologico Monzino
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: Sigrid Juséliuksen Säätiö
OpenAlex ID: W4405919500