Aortic Surgery Requiring Hypothermic Circulatory Arrest in Octogenarians

Background: Recent improvements in the outcomes of cardiovascular operation in octogenarians have resulted in an increase in the number of referrals of elderly patients for aortic surgery requiring hypothermic circulatory arrest. Methods: This was a retrospective chart review. Results: Between 2000 and 2007, 12 octogenarians with aortic aneurysms underwent surgery requiring hypothermic circulatory arrest. There were seven men with a median age of 83 years (range, 80-87 years). Diagnoses of aortic disease included acute type A aortic dissection in seven patients and degenerative thoracic aneurysm in five. Operation was performed through median sternotomy in eight patients and posterolateral thoracotomy in four. The median duration of hypothermic circulatory arrest was 50 minutes ( range, 15-84 minutes). Method of brain protection during hypothermia was selective antegrade cerebral perfusion in five patients, retrograde cerebral perfusion in two, and arrest alone in five. The hospital mortality rate was 8%. Major postoperative complications occurred in six (50%) patients, with transient neurologic dysfunction in two patients and no stroke. Conclusion: Although postoperative complications were common, the clinical outcome of aortic surgery requiring hypothermic circulatory arrest was acceptable.