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Article

Elective Ascending Aortic Aneurysm Surgery in the Elderly

by
Feyza Memis
1,†,
Carlijn G. E. Thijssen
1,2,†,
Arjen L. Gökalp
3,
Maximiliaan L. Notenboom
3,
Frederike Meccanici
1,
Mohammad Mostafa Mokhles
3,4,
Roland R. J. van Kimmenade
2,
Kevin M. Veen
3,
Guillaume S. C. Geuzebroek
5,
Jelena Sjatskig
3,6,
Franciscus J. ter Woorst
6,
Jos A. Bekkers
3,
Johanna J. M. Takkenberg
3 and
Jolien W. Roos-Hesselink
1,*
1
Department of Cardiology, Erasmus University Medical Center, 3015 CN Rotterdam, The Netherlands
2
Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
3
Department of Cardiothoracic Surgery, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
4
Department of Cardiothoracic Surgery, Utrecht University Medical Center, 3584 CX Utrecht, The Netherlands
5
Department of Cardiothoracic Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
6
Department of Cardiothoracic Surgery, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to the work.
J. Clin. Med. 2023, 12(5), 2015; https://doi.org/10.3390/jcm12052015
Submission received: 31 January 2023 / Revised: 24 February 2023 / Accepted: 27 February 2023 / Published: 3 March 2023
(This article belongs to the Special Issue Adult Congenital Heart Disease: An Increasing and Ageing Population: Part II)
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Abstract

Background. No clear guidelines exist for performing preventive surgery for ascending aortic (AA) aneurysm in elderly patients. This study aims to provide insights by: (1) evaluating patient and procedural characteristics and (2) comparing early outcomes and long-term mortality after surgery between elderly and non-elderly patients. Methods. A multicenter retrospective observational cohort-study was performed. Data was collected on patients who underwent elective AA surgery in three institutions (2006–2017). Clinical presentation, outcomes, and mortality were compared between elderly (≥70 years) and non-elderly patients. Results. In total, 724 non-elderly and 231 elderly patients were operated upon. Elderly patients had larger aortic diameters (57.0 mm (IQR 53–63) vs. 53.0 mm (IQR 49–58), p < 0.001) and more cardiovascular risk factors at the time of surgery than non-elderly patients. Elderly females had significantly larger aortic diameters than elderly males (59.5 mm (55–65) vs. 56.0 mm (51–60), p < 0.001). Short-term mortality was comparable between elderly and non-elderly patients (3.0% vs. 1.5%, p = 0.16). Five-year survival was 93.9% in non-elderly patients and 81.4% in elderly patients (p < 0.001), which are both lower than that of the age-matched general Dutch population. Conclusion. This study showed that in elderly patients, a higher threshold exists to undergo surgery, especially in elderly females. Despite these differences, short-term outcomes were comparable between ‘relatively healthy’ elderly and non-elderly patients.
Keywords: aortic aneurysm; elderly; aortic surgery; ascending aorta; aortic root aortic aneurysm; elderly; aortic surgery; ascending aorta; aortic root
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MDPI and ACS Style

Memis, F.; Thijssen, C.G.E.; Gökalp, A.L.; Notenboom, M.L.; Meccanici, F.; Mokhles, M.M.; van Kimmenade, R.R.J.; Veen, K.M.; Geuzebroek, G.S.C.; Sjatskig, J.; et al. Elective Ascending Aortic Aneurysm Surgery in the Elderly. J. Clin. Med. 2023, 12, 2015. https://doi.org/10.3390/jcm12052015

AMA Style

Memis F, Thijssen CGE, Gökalp AL, Notenboom ML, Meccanici F, Mokhles MM, van Kimmenade RRJ, Veen KM, Geuzebroek GSC, Sjatskig J, et al. Elective Ascending Aortic Aneurysm Surgery in the Elderly. Journal of Clinical Medicine. 2023; 12(5):2015. https://doi.org/10.3390/jcm12052015

Chicago/Turabian Style

Memis, Feyza, Carlijn G. E. Thijssen, Arjen L. Gökalp, Maximiliaan L. Notenboom, Frederike Meccanici, Mohammad Mostafa Mokhles, Roland R. J. van Kimmenade, Kevin M. Veen, Guillaume S. C. Geuzebroek, Jelena Sjatskig, and et al. 2023. "Elective Ascending Aortic Aneurysm Surgery in the Elderly" Journal of Clinical Medicine 12, no. 5: 2015. https://doi.org/10.3390/jcm12052015

APA Style

Memis, F., Thijssen, C. G. E., Gökalp, A. L., Notenboom, M. L., Meccanici, F., Mokhles, M. M., van Kimmenade, R. R. J., Veen, K. M., Geuzebroek, G. S. C., Sjatskig, J., ter Woorst, F. J., Bekkers, J. A., Takkenberg, J. J. M., & Roos-Hesselink, J. W. (2023). Elective Ascending Aortic Aneurysm Surgery in the Elderly. Journal of Clinical Medicine, 12(5), 2015. https://doi.org/10.3390/jcm12052015

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