Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Interact Cardiovasc Thorac Surg. 2022 Jan 18;34(2):283-290. doi: 10.1093/icvts/ivab256.
We investigated the effect of a preoperative age ≥80 years on postoperative outcomes in patients who underwent isolated elective total arch replacement using mild hypothermic lower body circulatory arrest with bilateral antegrade selective cerebral perfusion.
A total of 140 patients who had undergone isolated elective total arch replacement between January 2007 and December 2020 were enrolled in the present study. We compared postoperative outcomes between 30 octogenarian patients (≥80 years old; Octogenarian group) and 110 non-octogenarian patients (≤79 years old; Non-Octogenarian group).
Overall 30-day mortality and hospital mortality were 0% in both groups, and there was no significant difference in overall survival between the 2 groups (log-rank test, P = 0.108). Univariable Cox proportional hazard analysis showed that age as continuous variable was only the predictor of mid-term all-cause death (hazard ratio 1.08, 95% confidence interval 1.01-1.16; P = 0.037), but not in the Octogenarians subgroup (P = 0.119).
Preoperative age ≥80 years is not associated with worse outcomes postoperatively after isolated elective total arch replacement with mild hypothermic lower body circulatory arrest and bilateral antegrade selective cerebral perfusion.
我们研究了在使用低温下半身循环停止和双侧顺行选择性脑灌注进行择期全弓置换术的患者中，术前年龄≥80 岁对术后结果的影响。
本研究纳入了 2007 年 1 月至 2020 年 12 月期间接受择期全弓置换术的 140 例患者。我们比较了 30 例 80 岁以上高龄患者（≥80 岁；高龄组）和 110 例 79 岁以下非高龄患者（≤79 岁；非高龄组）的术后结果。
两组患者术后 30 天死亡率和院内死亡率均为 0%，两组患者的总生存率无显著差异（log-rank 检验，P=0.108）。单变量 Cox 比例风险分析显示，年龄作为连续变量仅预测中期全因死亡（风险比 1.08，95%置信区间 1.01-1.16；P=0.037），但在高龄组亚组中无此作用（P=0.119）。
在使用低温下半身循环停止和双侧顺行选择性脑灌注进行择期全弓置换术的患者中，术前年龄≥80 岁与术后结果不佳无关。
