title: Outcome after surgery for acute aortic dissection type A in the elderly: a single-center experience.
abstract: OBJECTIVE
  Despite improvements in surgical and perfusion techniques, surgery for acute aortic dissection type A (AADA) remains associated with high mortality rates. The aim of this study was to evaluate outcome after surgery for AADA in elderly in comparison with the outcome in younger patients.
  
  
  METHODS
  Between January 2004 and December 2012, 204 patients underwent operation for AADA. Of these, 65 patients were aged 70 years and older (elderly group; range, 70-85 years) and 139 were younger than 70 years (younger group; range, 18-69 years).
  
  
  RESULTS
  No significant differences were detected between the groups with regard to preoperative risk factors on admission. Significantly more number of elderly patients than younger underwent supracoronary replacement of the ascending aorta (93.8% versus 80.6%, p = 0.013). In comparison to the elderly patients, younger patients more frequently received complex surgery (Bentall and David operation). The mean extracorporeal circulation time (183 ± 62 minutes versus 158 ± 3 minutes; p = 0.003) and the mean aortic cross-clamp time (100 ± 45 minute versus 82 ± 30 minute; p = 0.006) were significantly higher for younger patients. No significant differences in postoperative complications and major morbidity were observed. The operative mortality (elderly group 4.6% versus younger group 1.4%; p = 0.33) and 30-day mortality (elderly group 18.5% versus younger group 8.6%; p = 0.06) were without statistical significance between the groups.
  
  
  CONCLUSIONS
  Surgery for AADA in the elderly resulted in acceptable mortality. Satisfactory outcomes should encourage the offering of surgery in these patients.
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Rouven
authors.initials: R
authors.lastname: Berndt
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Assad
authors.initials: A
authors.lastname: Haneya
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Jill
authors.initials: J
authors.lastname: Jussli-Melchers
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Insa
authors.initials: I
authors.lastname: Tautorat
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Kirstin
authors.initials: K
authors.lastname: Schmidt
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Aziz
authors.initials: A
authors.lastname: Rahimi
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Cremer
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein, Campus Kiel, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Schoeneich
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult