[Abdominal aortic aneurysms in patients over 80 years of age: conventional surgical treatment in 80 consecutive cases].
BACKGROUND
Abdominal aortic aneurysms (AAA) may be lethal unless appropriately and timely treated. Since age is a surgical risk, octogenarians are usually not considered as candidates for surgical intervention.


OBJECTIVE
To asses surgical complications and mortality in octogenarians treated for AAA.


METHODS
Patients aged 80 years older, treated consecutively between 1984-2001 were retrospectively analyzed.


RESULTS
Sixty one patients were male, and their age ranged from 80 to 95 years. All were treated with open surgery. The operation was elective in 58 and as an emergency in 22 patients (symptomatic or ruptured AAA). Aortic diameter was 6.8 +/- 1.4 cm in asymptomatic patients and 7.7 +/- 1.8 cm in emergency cases (p = 0.024). Thirty days postoperative mortality was 5.1% in elective surgery compared to 40.6% in emergency operations (p < 0.01). Five years survival rate was 44.7% in asymptomatic patients compared to 10.4% in the emergency cases (p < 0.023).


CONCLUSIONS
Elective surgery for asymptomatic AAA can be performed with low operative mortality in octogenarians. However, surgery in emergency cases has an 8 fold increase in risk. Accordingly, octogenarian patients should be considered for elective AAA repair in a selective basis.
Valdés
Francisco
F
Departamento de Enfermedades Cardiovasculares, División de Cirugía, Facultad de Medicina, Hospital Clínico Pontificia Universidad Católica de Chile. franval@med.puc.cl
Bergoeing
Michel
M
Krämer
Albrecht
A
Mertens
Renato
R
Canessa
Roberto
R
Lema
Guillermo
G
Garayar
Bernardita
B
Urzúa
Jorge
J
D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis