The correlation of age and extension length in DeBakey type I aortic dissection

• Verfasst von: Merkle-Storms, Julia [VerfasserIn]
• Verfasst von: Gaisendrees, Christopher [VerfasserIn]
• Verfasst von: Feißt, Manuel [VerfasserIn]
• Verfasst von: Rylski, Bartosz [VerfasserIn]
• Verfasst von: Dohle, Daniel-Sebastian [VerfasserIn]
• Verfasst von: Hagl, Christian Matthias [VerfasserIn]
• Verfasst von: Lescan, Mario [VerfasserIn]
• Verfasst von: Brickwede, Jens [VerfasserIn]
• Verfasst von: Poeling, Jochen [VerfasserIn]
• Verfasst von: Holubec, Tomas [VerfasserIn]
• Verfasst von: Etz, Christian D. [VerfasserIn]
• Verfasst von: Jawny, Philipp [VerfasserIn]
• Verfasst von: Noack, Thilo [VerfasserIn]
• Verfasst von: Arif, Rawa [VerfasserIn]
• Verfasst von: Wahlers, Thorsten [VerfasserIn]
• Verfasst von: Boening, Andreas [VerfasserIn]
• Verfasst von: Lühr, Maximilian [VerfasserIn]
• Titel: The correlation of age and extension length in DeBakey type I aortic dissection
• Titelzusatz: are older patients over 70 years at a lower risk?
• Verf.angabe: 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
• E-Jahr: 2023
• Jahr: 27 April 2023
• Umfang: 9 S.
• Fussnoten: Gesehen am 29.08.2023
• Titel Quelle: Enthalten in: European journal of cardio-thoracic surgery
• Ort Quelle: Oxford : Oxford Univ. Press, 1987
• Jahr Quelle: 2023
• Band/Heft Quelle: 63(2023), 6 vom: Juni, Artikel-ID ezad175, Seite 1-9
• ISSN Quelle: 1873-734X
• DOI: doi:10.1093/ejcts/ezad175
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1858177863

Abstract

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.