[Surgery of aneurysm of the subrenal abdominal aorta in patients over 80 years of age].
In patients aged over 80 years infrarenal aortic aneurysmectomy is controversial because of reduced life expectancy and multiple risk factors and associated vascular or non-vascular lesions. Our personal experience of 984 operations performed for unruptured abdominal aortic aneurysms over a 6-year period showed a significantly higher perioperative mortality in patients aged more than 80 years (15.4 versus 2 percent). In contrast, for ruptured aneurysms, the difference of perioperative mortality was not significant (71 percent in the over 80 group versus 37 percent in other groups), but the number of patients (17 and 52 respectively, to a total of 69) was too small. In patients over 80, it seems reasonable to restrict elective surgery to aneurysms that are symptomatic or complicated, or to those which carry higher risks of rupture in view of their diameter and gradual enlargement. The best treatment, in fact, is early diagnosis and surgery before the age of 80, when perioperative mortality is much lower, less than 2 percent. Less aggressive treatments, including endoluminal aortic graft placement, are very promising but still experimental.
Cormier
F
F
Clinique de La Défense, Nanterre.
Veroux
P
P
Fichelle
J M
JM
Marzelle
J
J
Cormier
J M
JM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors
La chirurgie des anévrismes de l'aorte abdominale sous-rénale au-delà de 80 ans.