HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hafil B Abdulgani Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Abdulgani, H. B Search for Related Content PubMed PubMed Citation Articles by Abdulgani, H. B Related Collections Great vessels Pericardium

Outcome of Cardiac and Thoracic Aortic Operation in Patients Over 80 Years Old

Division of Cardiothoracic Surgery Department of Surgery Hasan Sadikin General Hospital Padjadjaran University Medical Faculty 38 Jalan Pasteur Bandung 40161, Indonesia

I read with utmost interest the article by Kawachi and colleagues.¹ Although numerous data are available on the results of coronary artery bypass in octogenarians, information on the outcome of thoracic aortic operations in this population subset is limited. The investigators reported an outstanding 14% mortality in patients over 80 years old with acute Stanford type A dissection of the thoracic aorta, who underwent surgery on an emergency basis. This reflects the center’s prompt and impeccable diagnoses. Advanced emergency-room transesophageal echocardiography and other noninvasive diagnostic resources presumably serve as landmark. Nevertheless, intraoperative strategy and postoperative management attenuate the prognosis in many centers and remain critical challenges to many surgeons around the world. In our limited experience, acute dissecting aneurysms of the ascending thoracic aorta often turn out to necessitate hemiarch replacement. The retrograde cerebral perfusion technique has contributed toward good midterm survival with intact neurological status in our octogenarian patients.

Without wishing to be antipodal, I would like to express concern regarding the dissonant results of other investigators, reflected on by these authors in their article. Perhaps, in order to delineate pitfalls, we should also identify mortality and morbidity based on the extent of dissection (DeBakey/Crawford type) rather than on the site of the intimal tear (Stanford type) alone. Limited diagnostic resources, such as in our center, as well as limited classification, may lead to deleterious intra-operative consequences and dismal outcome.

REFERENCE

1. Kawachi Y, Nakashima A, Toshima Y, Kimura S, Arinaga K. Outcome of cardiac and thoracic aortic operation in patients over 80 years old. Asian Cardiovasc Thorac Ann 2002;10:12–5.[Abstract/Free Full Text]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hafil B Abdulgani Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Abdulgani, H. B Search for Related Content PubMed PubMed Citation Articles by Abdulgani, H. B Related Collections Great vessels Pericardium