Aortic dissection in elderly patients

: We performed 12 operations for aortic dissection in octogenarians from 1997 to 2004. Male : female = 1 : 11. Mean duration of follow-up is 33 +/- 19 months. As regards the etiology, acute type A aortic dissection was 8, chronic type A aortic dissection was 3 and chronic type B aortic dissection with distal arch aneurysm was 1. Total arch replacement was performed in 2 patients and hemiarch replacement in 10. In all patients with acute type A aortic dissection, hemiarch replacement was performed with the aid of selective cerebral perfusion or deep hypothermic circulatory arrest with retrograde cerebral perfusion. Postoperative respiratory failure was found in 1 patient, re-exploration for bleeding in 1, mediastinitis in 1 and temporary neurological dysfunction in 1. There was no hospital mortality. Two patients were died of respiratory failure 4 and 27 months after surgery. The results were acceptable. We recommend that age should not be the only determinant in deciding whether emergency operation should be performed in octogenarians.