Department of Cardiovascular Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Yanta West Road No. 277, Xi'an 710061, China.
Department of Thoracic & Cardiovascular Surgery, Xi'an Central Hospital of Xi'an Jiaotong University, Xiwu Road No. 16, Xi'an 710003, China.
J Int Med Res. 2022 Jun;50(6):3000605221109377. doi: 10.1177/03000605221109377.
The effect of patient age on the outcome of Sun's procedure for acute type A aortic dissection (ATAAD) remains controversial. We retrospectively investigated the early outcomes of Sun's procedure in elderly patients with ATAAD in our single center.
This study involved 106 patients who underwent Sun's procedure. The patients were divided into the elderly group (≥70 years, n = 17) and younger group (<70 years). Baseline, intraoperative, and postoperative data were compared between the groups.
The mean age in the elderly and younger groups was 75.7 and 50.7 years, respectively. The type of aortic root operations were not significantly different between the groups. Concomitant surgeries were more frequently performed in the elderly group, but without statistical significance. All intraoperative cardiopulmonary bypass variables as well as the in-hospital and 30-day mortality rates were similar between the groups. The incidences of most postoperative complications were also similar except for a higher incidence of sepsis in the elderly group.
Emergency performance of Sun's procedure for patients with ATAAD characterized by dissection and/or entry tear in the aortic arch should not be denied on the basis of advanced age alone. Comparable early in-hospital outcomes can be achieved in elderly patients.
患者年龄对 Sun 手术治疗急性 A 型主动脉夹层（ATAAD）的效果仍存在争议。我们回顾性研究了单一中心老年 ATAAD 患者行 Sun 手术的早期结果。
本研究纳入了 106 例行 Sun 手术的患者。患者分为老年组（≥70 岁，n=17）和年轻组（<70 岁）。比较两组间的基线、术中及术后数据。
老年组和年轻组的平均年龄分别为 75.7 岁和 50.7 岁。两组主动脉根部手术类型无显著差异。老年组更常进行合并手术，但无统计学意义。所有术中体外循环变量以及院内和 30 天死亡率在两组间相似。大多数术后并发症的发生率也相似，除了老年组的感染率较高。
对于以主动脉弓夹层和/或入口撕裂为特征的 ATAAD 患者，不应仅因高龄而拒绝行紧急 Sun 手术。老年患者可获得相似的早期院内转归。
