| Early and Mid-Term Survival and
Quality of Life after Thoracic Aortic Surgery in Patients Aged
70 Years and Older |
（Department of Cardiovascular Surgery and The Department
of Clinical Study, National Kyushu Medical Center Hospital, Fukuoka,
Japan)
| Isao Komesu |
Kouichi Arinaga |
Atuhiro Nakashima |
| Yoshihiro Toshima |
Satoshi Kimura |
Kenji Ishihara |
| Yoshito Kawachi |
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The early and mid-term survival
after thoracic aortic surgery and the influence of age on operative
mortality were examined in 93 consecutive patients from August
1994 to June 1999, together with assessment of postoperative
quality of life (QOL). The mean age was 63.8±11.6 years old (range
26 to 84 years) and 65 patients were male. Aneurysms were atherosclerotic
in 43 patients and aortic dissection was present in 50. Forty-eight
(52%) required emergency operation. Operative procedures consisted
of ascending aorta or hemiarch replacement in 23 patients, Bentall's
operation was performed in 4, total arch replacement in 31, distal
arch replacement in 9，descending aorta replacement in 13, replacement
of the thoracoabdominal aorta in 6, and patch repair in 7. These
patients were divided into two groups: the under 70 group (Y
group, n＝61) and the 70 or older group (O group, n＝32). Current
QOL of the survivors was assessed using the Asanoi method with
a mailed questionnaire. There were 13 early deaths (14%). There
were 10 late deaths (5.6%/P-Y（Patients-Years）). The actuarial
survival rate of the Y group was significantly higher than that
of the O group (p＝0.0412). Perioperative stroke was seen in 11%
of the Y group and 16 % of the O group. These patients had a
high mortality rate (Y group 43 %, O group 100 %) during early
and long term follow-up periods. The postoperative NYHA category
and exercise ability of the O group were better than those of
the Y group. We obtained satisfactory answers concerning the
results of operation in the majority of current survivors. Patients
aged 70 years and older could undergo thoracic aortic surgery
with reasonable risk. QOL following operation was satisfactory
except in patients with merged perioperative stroke.
Jpn. J. Cardiovasc. Surg. 30: 177-181 (2001) |
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