Thoracic aortic emergencies in octogenarians

Ruptured thoracic or thoracoabdominal aortic aneurysm, ruptured Stanford type B aortic dissection and acute Stanford type A aortic dissection are catastrophic event. Aggressive surgical treatment for octogenarians suffered from above mentioned event is in controversy, because the result of surgery is extreme poor. During recent 17 months period, we experienced 7 cases of aged 80 years or elder patients with thoracic aortic emergencies. Immediate surgery was performed for all patients except for 2 patients with acute Stanford type A aortic dissection. Among 5 patients received surgery, 3 patients survived and discharged. And 2 of these 3 patients reverted completely and recovered their activity. However, 2 patients died in hospital (hospital mortality 40%). A 92-year-old woman suffered from ruptured thoracoabdominal aneurysm died during operation due to low output syndrome, and an 80-year-old man suffered from ruptured aortic arch aneurysm died 69 days after operation due to respiratory failure. Two patients with Stanford type A aortic dissection those who were not able to receive surgical treatment died of cardiac tamponade. Indeed the operative mortality is extreme poor, aggressive emergent surgery should be considered to salvage octogenarians suffered from thoracic aortic emergencies, because aggressive surgery is the only hope for survival.