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- Title
004AORTIC ARCH SURGERY FOR OCTOGENARIANS: IS IT JUSTIFIED?
- Authors
Kurazumi, H.; Mikamo, A.; Kudo, T.; Suzuki, R.; Takahashi, M.; Shirasawa, B.; Zempo, N.; Hamano, K.
- Abstract
Objectives: The progress of medical care has resulted in a significant increase in the number of elderly people worldwide. However, elderly patients are commonly denied aortic arch surgery due to the perception of poor clinical outcomes. We retrospectively evaluated mid-term clinical outcomes and quality of life (QoL) of octogenarian patients.Methods: Forty-nine consecutive patients aged >80 years were separated into two groups: group S (n = 20) underwent surgical treatment, whereas group M patients (n = 29) were treated medically. Kaplan-Meier survival analysis was performed, and QoL was assessed using the Short-Form 36 questionnaire. Risk factors for mortality were determined using the Cox hazard regression model.Results: Five-year survival was 61.5% in group S and 13.6% in group M (P = 0.02). Freedom from aorta-related death at five years was 92.3% in group S and 32.4% in group M (P = 0.01). The 61.5% survival probability of group S patients at five years was identical to the predictive survival rate of 66.2% calculated from a sex- and age-matched Japanese population, whereas the 13.6% survival probability of group M patients was significantly lower than the predictive survival rate of 66.9% (P < 0 001). Among the mid-term survivors, the QoL of group S patients was equivalent to that of group M patients. Cox hazard regression analysis revealed that only medical therapy was a risk factor for mortality.Conclusions: Aortic arch surgery for octogenarians can yield satisfactory clinical outcomes as well as adequate daily activity. These findings indicate that age alone should not disqualify octogenarian patients from aortic arch intervention.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2013, Vol 17, Issue suppl_2, pS69
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivt372.4