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Peterss, Sven; Mansour, Ahmed M.; Zafar, Mohammad A.; Thombre, Kabir; Rizzo, John A.; Ziganshin, Bulat A.; Darr, Umer M.; Elefteriades, John A. (2017): Elective surgery for ascending aortic aneurysm in the elderly: should there be an age cut-off? In: European Journal of Cardio-thoracic Surgery, Vol. 51, No. 5: pp. 965-970
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OBJECTIVES: The objective of this study is to retrospectively analyse surgical outcomes in patients aged 75-79, and 80 and above. METHODS: Between 2000 and 2015, 108 patients aged 75-79 (G(75), mean age 76.9 +/- 1.5years) and 72 patients aged 80 and above (G(80), mean age 82.2 +/- 2.1years) underwent elective aneurysm repair. Operative outcome and survival was compared with 727 contemporary younger counterparts aged <75 years (G(Ctrl), mean age 56.6 +/- 11.7years). RESULTS: Postoperatively, patients with advanced age showed a higher incidence of prolonged ventilation (G(80) 21.4%, G(75) 8.4%, G(Ctrl) 2.9%;P < 0.001), low cardiac output syndrome (G(80) 11.4%, G(75) 1.9%, G(Ctrl) 2.2%;P = 0.001), multi organ failure (G(80) 2.9%, G(75) 0%, G(Ctrl) 0.1%;P = 0.022), haemofiltration (G(80) 8.6%, G(75) 0.9%, G(Ctrl) 0.6%;P < 0.001), and infection (G(80) 10.0%, G(75) 6.5%, G(Ctrl) 3.5%;P = 0.017). Operative mortality was significantly increased in the elderly (G(80) 11.1%, G(75) 3.7%, G(Ctrl) 1.4%;P < 0.001). Mid-term survival differed significantly between the surgical groups. Multivariate regression analysis precluded age as an independent predictor of operative mortality. CONCLUSIONS: Elderly patients showed a higher operative risk compared to their younger counterparts. However, age per se is no suitable indicator of surgical risk and well-selected patients with large threatening aneurysms may benefit from intervention.