Prognosis of type A acute aortic syndrome in elderly patients

• DOI: 10.1093/ehjacc/zuae036.117
• Publication Date: 2024-05-09T00:08:21Z
• Authors: I Ramos Gonzalez-...; C Ferrera; I Vilacosta; A Carrero; F Gutierrez; J Gonzalez Del Ca...; M J Dominguez; E Alvarez; F Fernandez; I Martinez; J Cobiella; F J Noriega; A Viana-Tejedor; J Perez Villacastin; L Maroto-Castellanos
• Keywords: Acute aortic syndrome

Abstract Funding Acknowledgements None. Introduction Type A acute aortic syndrome (AAS-A) is associated with a high mortality. Emergent surgery the treatment of choice for patients AAS-A. However, this highly complex procedure significant morbidity. There are uncertainties about best strategy elderly patients, which pose challenge in clinical practice. Purpose The aim study to evaluate prognosis AAS-A and analyse impact outcome patient population. Methods Patients were prospectively consecutively collected from April-2019 March-2023 four-hospital network tertiary care referral centre cardiac surgery. classified according age into two groups: ≥75 years under 75 years. Clinical, diagnostic, prognostic variables analysed. Results total 113 AAS included, whom 82 patients. Of these, 27 aged or older. Older had more comorbidities: COPD, atrial fibrillation, renal failure stroke (table). Elderly diagnosed later (symptom-to-diagnosis time: 10 hours (6.2-62) vs. 4 (2.2-23), p=0.004). At diagnosis, older complications: tamponade (33% vs 23%, p= 0.352), hemopericardium (69% 38%, 0.01), shock (45% 30%, p=0.180) (40% 20%, 0.132). surgical risk was higher (table) they underwent lower proportion (59.3% 87.3%, 0.004). Once diagnosed, time similar between groups (3.2h (1.6-10) 2.7h (2.1-5.7), 0.728). Despite increased risk, mortality reduction both (figure). In who surgery, incidence post-surgical fibrillation group no differences remaining complications Conclusion have comorbidities, than those younger age. this, even Age alone should not be contraindication AAS-A.Mortality SAA by