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Elective Hypothermic Circulatory Arrest to Address Aortic Pathology Is Safe for the Elderly
Author(s) -
Reece T. Brett,
Tribble Curtis G.,
Peeler Benjamin B.,
Singh R. Ramesh,
Gazoni Leo M.,
Kron Irving L.,
Kern John A.
Publication year - 2009
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2008.00793.x
Subject(s) - medicine , ascending aorta , intensive care unit , aortic arch , circulatory system , thoracic aorta , deep hypothermic circulatory arrest , stroke (engine) , confusion , aorta , aortic valve , cardiology , surgery , cerebral perfusion pressure , mechanical engineering , psychology , psychoanalysis , engineering , cerebral blood flow
Abstract Background: Due to assumptions of excessive risk, hypothermic circulatory arrest (HCA) has been considered prohibitive in elderly patients. However, as more elderly patients are referred for assessment of difficult aortic valve, ascending aorta, and aortic arch pathology, the risk of HCA in these patients needs to be addressed. We hypothesized that the use of HCA would not increase mortality or complications in elderly patients compared to younger counterparts. Methods: We retrospectively reviewed the charts of adult patients who underwent elective HCA between January 1995 and June 2007. Of 147 procedures, 45 patients were ≥75 years old. These patients were compared to their younger counterparts in terms of comorbidities, operations, and complications. Results: Comparing patients ≥75 years old to their younger counterparts revealed no significant differences in outcomes including nearly identical rates of confusion (≥75 15% vs <75 9%, p > 0.5) and stroke (≥75 11% vs <75 7%, p > 0.2). There was also no difference in 30‐day mortality (≥75 7% vs <75 7%, p = 0.9). Lengths of hospital stays and intensive care unit stays were longer in the older patients, but this was not statistically significant. Conclusion: In this study, elderly patients faired well with HCA compared to younger patients. These data suggest that the use of HCA is safe in selected elderly patients. Elderly patients should be considered for indicated procedures of the aortic valve, ascending aorta, and aortic arch regardless of age.