8. Does age affect survival in aortic dissection? 15 years single centre experience

Abstract

Type A aortic dissection if one of the few cardiac surgical emergencies that requires prompt recognition and treatment to achieve good outcome. Our aim is to evaluate our centre experience in surgical treatment of type A aortic dissection and to assess if the outcomes have changed over the years with the increase in experience. We also studied the effect of the patient’s age and technique of repair (open vs. close) in terms of survival, blood products consumption and duration of cardiopulmonary bypass. Methods: We identified patients who had surgery for type A aortic dissection from a prospectively collected database and theatre logbooks in the period (1998–2013). Details of cardiopulmonary bypass, blood products consumption were provided from perfusion department and blood bank databases. Patients’ long terms survival data obtained by contacting the patients’ GPs. R statistical platform was used for statistical analysis. Results: A total of 152 patients were identified and 145 patients were included in the analysis. Our results showed that survival has not improved with the increase in centre experience. Older patients at the age of 60 or above had similar survival to younger patients. The use of open vs. closed technique had no significant effect on survival. Conclusion: Survival following surgery for type A aortic dissection is not affected by age of the patient. Therefore, older patients should not be denied surgical repair based on age alone. Experience did not alter outcome, which indicates that calls for centralization of emergency aortic surgery may not be supported by strong evidence.