In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
Abstract:
Introduction: Elderly patients have been suggested to be more prone to acute aortic dissection due to a higher incidence of age-related atherosclerosis and stiffness of the thoracic aorta. Hypothesis: Younger patients suffer more extensive DeBakey type I dissections due to aortic wall integrity, potentially allowing unhindered extension. The study's aim was to correlate age and dissection extension length in a large contemporary multi-center cohort. Methods: The perioperative data of 3385 patients with acute aortic dissection were retrospectively analyzed with regard to postoperative outcome and dissection extent. DeBakey type I aortic dissections (n=2510) were identified and divided into two groups: 〈 70 years (n=1741) and 〉 70 years (n=769). Patients with DeBakey type II and connective tissue disease were excluded (n=875). Results: Septuagenarians ( 〉 70 yrs) had a higher incidence of atherosclerosis (32.0% vs. 18.9%; p 〈 0.001) and showed significantly more often a limitation of dissection extension until the aortic arch level (40.9% vs. 29.2%; p 〈 0.001). In younger patients, aortic dissections involved the supraaortic vessels more often (52.0% vs. 40.1%; p 〈 0.001) and extended significantly further downstream the aorta: descending aorta (68.5% vs. 57.1%; p 〈 0.001), abdominal aorta (54.7% vs. 42.0%; p 〈 0.001) and iliac bifurcation (36.6% vs. 26.0%; p 〈 0.001) ( Fig.1 ). Clinically, younger patients presented with significantly higher incidences of preoperative cerebral (p=0.002), spinal (p=0.003), visceral (p=0.002) and peripheral (p 〈 0.001) malperfusion. In-hospital mortality rates in patients 〈 70 yrs and 〉 70 yrs were 18.9% and 22.2% (p=0.067), respectively. Conclusions: Extensive DeBakey type I aortic dissection is less frequent in septuagenarians. Conversely, younger patients suffer significantly more often from preoperative organ malperfusion and associated complications. Postoperative mortality remains high irrespective of age groups.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.144.suppl_1.10165
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
1466401-X
