The correlation of age and extension length in DeBakey type I aortic dissection: are older patients over 70 years at a lower risk?
Age-related atherosclerosis has been shown to cause aortic stiffness and wall rigidification. This analysis aimed to correlate age and dissection extension length in a large contemporary multicentre study. We hypothesize that younger patients suffer more extensive DeBakey type I dissection due to ao...
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
27 April 2023
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| In: |
European journal of cardio-thoracic surgery
Year: 2023, Volume: 63, Issue: 6, Pages: 1-9 |
| ISSN: | 1873-734X |
| DOI: | 10.1093/ejcts/ezad175 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/ejcts/ezad175 Verlag, lizenzpflichtig, Volltext: https://academic.oup.com/ejcts/article/63/6/ezad175/7146030 
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| Author Notes: | Julia Merkle-Storms, Christopher Gaisendrees, Manuel Feisst, Bartosz Rylski, Daniel-Sebastian Dohle, Christian Hagl, Mario Lescan, Jens Brickwede, Jochen Poeling, Tomas Holubec, Christian D Etz, Philipp Jawny, Thilo Noack, Rawa Arif, Thorsten Wahlers, Andreas Boening and Maximilian Luehr |
| Summary: | Age-related atherosclerosis has been shown to cause aortic stiffness and wall rigidification. This analysis aimed to correlate age and dissection extension length in a large contemporary multicentre study. We hypothesize that younger patients suffer more extensive DeBakey type I dissection due to aortic wall integrity, allowing unhindered extension within the layers.The perioperative data of 3385 patients from the German Registry for Acute Aortic Dissection Type A were retrospectively analyzed with regard to postoperative outcomes and dissection extension. Patients with DeBakey type I aortic dissection (n = 2510) were retrospectively identified and divided into 2 age groups for comparison: ≤69 years (n = 1741) and ≥70 years (n = 769). Patients with DeBakey type II dissection or connective tissue disease were excluded from the analysis.In younger patients (≤69 years), aortic dissection involved the supra-aortic vessels significantly more often (52.0% vs 40.1%; P < 0.001) and extended significantly further downstream the aorta: descending aorta (68.4% vs 57.1%; P < 0.001), abdominal aorta (54.6% vs 42.1%; P < 0.001) and iliac bifurcation (36.6% vs 26.0%; P < 0.001). Consequently, younger patients also presented with significantly higher incidences of preoperative cerebral (P < 0.001), spinal (P < 0.001), visceral (P < 0.001), renal (P = 0.013) and peripheral (P < 0.001) malperfusion. In older patients (≥70 years), dissection extent was significantly more often limited to the level of the aortic arch (40.9% vs 29.2%; P < 0.001). No significant difference was found with regard to 30-day mortality (20.7% vs 23.6%; P = 0.114).Extensive DeBakey type I aortic dissection is less frequent in older patients ≥70 years than in younger patients. In contrast, younger patients suffer more often from preoperative organ malperfusion and associated complications. Postoperative mortality remains high irrespective of age groups. |
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| Item Description: | Gesehen am 29.08.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1873-734X |
| DOI: | 10.1093/ejcts/ezad175 |