Elective Open Operation for Abdominal Aortic Aneurysm in Octogenarians—Survival Analysis of 105 Patients

Abstract

The number of AAA operations in octogenarians has increased considerably during 20 years. Octogenarians operated electively for AAA has higher 30-day mortality as compared to younger patients. Their long-term survival appears similar to a matched control group. The benefit of surgery must be carefully considered against the perioperative risk, especially for the oldest octogenarians.

Abdominal aortic aneurysm surgery for octogenarians

“…8,9 Operative mortality in octogenarians is reported to range from 5.7% to 10.5%. 5,8,9 In the present series, the prognosis of patients treated nonoperatively deteriorated once the AAA diameter had reached a critical point of 6 cm. Of the 23 octogenarians with an AAA smaller than 6 cm in diameter, 12 died; none of rupture.…”

“…There are many reports on AAA surgery in octogenarians, but most focus on the safety of surgery in relation to patients undergoing AAA operations. 4,5,7 There are few papers discussing the prognosis of patients treated nonoperatively or operatively, as in the present study. 8,9 Operative mortality in octogenarians is reported to range from 5.7% to 10.5%.…”

“…[1][2][3] The operative mortality associated with elective AAA surgery has declined remarkably in recent years, and it is now considered a relatively safe operation; however, its indications for patients of advanced age remain unclear. 4,5 To investigate the indications of AAA surgery for octogenarians, we analyzed the results of surgery, postoperative surveillance, and quality of life (QOL), and reviewed the results of patients treated nonoperatively. The objective of this study was to clarify the indications of AAA surgery for octogenarians in comparison with those for in septuagenarians.…”

Evaluation of endovascular abdominal aortic aneurysm repair in nonagenarians

“…With respect to AAA patients in good anatomical condition, endovascular aortic repair (EVAR) has become the first choice in place of traditional open operations. Although several studies have revealed that the mortality rate and incidence of complications in patients aged 80 years and older during the operation period and in the medium to long term were higher than those of younger patients, almost all authors have indicated that if preoperative evaluations are conducted, the results of EVAR technology would nonetheless be satisfactory (Brinkman et al, 2004;Haug et al, 2005;Henebiens et al, 2008). Therefore, for symptomatic AAA patients aged 90 or older, decision-makers should primarily focus on the risk of repair and on subjective issues related to life expectancy.…”

Laparoscopic abdominal aortic aneurysm repair in octogenarians

“…[1][2][3][4][5][6] Limited functional reserve of octogenarians has stimulated the use of minimally invasive techniques, mainly endovascular aneurysm repair (EVAR). [7][8][9][10][11][12][13][14] However, direct aortic repair (DAR) with aneurysmorraphy and bypass graft interposition remains a reliable and suitable alternative in selected octogenarians.…”