Outcome of treatment for Stanford type A acute aortic dissection in over 85 years old patients – Medical or Surgical? -

P0237 

Abstract Submission 

Yuta Kanazawa (1), Hirotsugu Fukuda (2), Masahiko Ezure (3)

(1) Dokkyo Medial University Hospital, Japan, (2) Dokkyo Medial University Hospital, Mibu,Tochigi, Japan, (3) Gunma Prefectural Cardiovasvular Center, Maebashi, Gunma

Yuta Kanazawa    -  Contact Me
Dokkyo Medial University Hospital

Hirotsugu Fukuda    -  Contact Me
Dokkyo Medial University Hospital

Masahiko Ezure    -  Contact Me
Gunma Prefectural Cardiovasvular Center

Yuta Kanazawa    -  Contact Me
N/A

We reviewed our outcomes of treatment for Stanford Type A acute aortic dissection (TAAD) in over 85 years old patients.

In January 2010- August 2019, 41 patients at over 85 years old had diagnosed TAAD. We compare the outcomes between the surgical treatment group (N=23) and the medical treatment group (N=18).

There were no significant differences in the patient's characteristics between each group. All operative procedure was ascending aorta graft replacement.
In the surgical treatment group, hospital mortality was 17% (4/23 cases). Only five patients were discharged without any complications (22%). The remaining 14 patients transferred to other hospital for any other complications or rehabilitation.
In the medical treatment group, hospital mortality was 28% (5/18 cases). Only four patients were discharged without any complications (22%). The remaining 9 patients transferred to other hospital.
The average follow-up period was 450 days and the follow up rate was 95.1%In Kaplan-Meier survival analysis, there was no significant difference in the overall survival. But 1-year survival rate of surgical treatment group was 71.5% and better than that of medical treatment group (55.0%)

We cannot say that the outcomes of surgical treatment for TAAD patients at over 85 years old was overwhelming better than that of medical treatment. Therefore, we should consider the treatment strategy more carefully for an individual patient.

Dissection