Thoracoabdominal and descending thoracic aortic aneurysm surgery in patients aged 79 years or older.
OBJECTIVE
Advanced age has been reported as a predictor of increased morbidity and mortality in patients who undergo major cardiovascular reconstructive surgery. In this study, we evaluated the outcome of patients aged 79 years or older after thoracoabdominal and descending thoracic aortic aneurysm repair.


METHODS
From February 1991 to May 2001, 854 patients underwent operation for thoracoabdominal or descending thoracic aortic aneurysm. Fifty-six patients were between the ages of 79 and 88 years at the time of surgery, and these patients were included in this study. Risk factors were analyzed for their impact on mortality and morbidity in these elderly patients with univariate analysis.


RESULTS
In patients at low risk, the 30-day mortality rate was 7/42 (17%), compared with 7/14 (50%) in patients at high risk with emergency presentation, congestive heart failure, or diabetes (P <.03). Four patients (7%; 4/56) had neurologic deficits develop. No single preoperative risk factor was significantly associated with increased mortality or neurologic deficits.


CONCLUSIONS
Thoracoabdominal and descending thoracic aortic aneurysm repair in elderly patients can be undertaken with acceptable mortality and morbidity, provided that patients are selected appropriately.
Huynh
Tam T T
TT
Department of Cardiothoracic and Vascular Surgery, Memorial Hermann Hospital and The University of Texas Health Science Center at Houston, 77030, USA.
Miller
Charles C
CC
Estrera
Anthony L
AL
Porat
Eyal E
EE
Safi
Hazim J
HJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology* / Q000401:mortality*; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors