Early and mid-term results after thoracic aortic surgery in patients aged over 70: survival and effect of the age factor.
OBJECTIVE
The increase in the life span of the Japanese population over the past decade has resulted in a significant increase in elderly patients in cardiac and aortic surgery. This study describes the early and mid-term survival after thoracic aortic surgery, and the influence of age on the operative mortality.


METHODS
A total of 85 consecutive patients aged over 70 years underwent a thoracic aortic operation at our institution from January 1995 to June 2005. Their mean age was 76.2 +/- 4.6 years. Their preoperative risk scores were classified into 5 groups (good, fair, poor, high, extremely high) based on the Parsonnet method.


RESULTS
There were 10 operative and hospital deaths (11.8%). The survival rates for all patients were 77.8%, 69.4%, and 58.2% at 1, 3, and 5 years, respectively. The major complication was respiratory failure. According to the Parsonnet model, the observed mortality was lower than the predicted mortality. When the age score was excluded in the Parsonnet model, the observed mortality became almost equal to the predicted mortality except in the high-risk group.


CONCLUSIONS
Patients aged over 70 years will undergo thoracic aortic surgery with a reasonable chance of recovery unless there are major preoperative complications. We should consider whether elective surgery can be performed on elderly patients before a rupture develops.
Kunishige
Hideyuki
H
Division of Cardiovascular Surgery, National Hospital Organization Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan. kunishig@sap-cc.go.jp
Myojin
Kazuhiro
K
Ishibashi
Yoshimitsu
Y
Ishii
Koji
K
Kawasaki
Masakazu
M
Oka
Junichi
J
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male