Open Aortic Surgery
Sprache: D/E
Slides: E
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How to teach Open Aortic Repair with Decreasing Caseload
- Präsentationszeit:
- 12 min
- Diskussionszeit:
- 3 min
ReferentIn: Jürg Schmidli (Bern)
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Decision Making Open vs. Endo
- Präsentationszeit:
- 7 min
- Diskussionszeit:
- 3 min
ReferentIn: Andreas Peters (Heidelberg)
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Structure of Dedicated Aortic Teams - how many Trainees can we Teach?
- Präsentationszeit:
- 7 min
- Diskussionszeit:
- 3 min
ReferentIn: Joscha Mulorz (Düsseldorf)
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Genetic Disorders- Always Open?
- Präsentationszeit:
- 7 min
- Diskussionszeit:
- 3 min
ReferentIn: Michael Jacobs (Berlin)
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Open Aortic Surgery Techniques for Individualized Hybrid Approaches
- Präsentationszeit:
- 7 min
- Diskussionszeit:
- 3 min
ReferentIn: Maani Hakimi (Luzern)
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Open Aortic Surgery as an Option after Failed Endovascular Treatment
- Präsentationszeit:
- 7 min
- Diskussionszeit:
- 3 min
ReferentIn: Jürgen Falkensammer (Linz)
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Organ Protection in Thoracoabdominal Aortic Replacement: Which Strategies are Most Effective?
- Präsentationszeit:
- 7 min
- Diskussionszeit:
- 3 min
ReferentIn: Drosos Kotelis (Bern)
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Open Surgical Repair of Complex Abdominal Aortic Aneurysms in Octogenarians is Associated with Increased Risk of Short-Term Mortality and Major Adverse Events but Not Increased Mid-Term Mortality or L
- Präsentationszeit:
- 7 min
- Diskussionszeit:
- 3 min
Vortragender AutorIn: Giorgio Prouse (Lugano)
Zielsetzung
To assess short- and mid-term outcomes—including 30-day mortality, major adverse cardiovascular events (MACE), and hospital length of stay (LOS)—in octogenarians undergoing open surgical repair of complex abdominal aortic aneurysms (cAAA), compared to a younger population.
Methoden
We retrospectively analysed a prospectively maintained database of patients who underwent open repair for cAAA at two tertiary vascular surgery centres. Patients with ruptured aneurysms, dissections, or failed EVAR were excluded. The cohort was divided into two groups: Group I (age ≥80 years) and Group II (<80 years). Primary outcomes included 30-day mortality, MACE, and early re-interventions. Secondary outcomes were LOS, mid-term survival, and re-intervention rates. Multivariable logistic regression and Cox proportional hazards models were used to evaluate outcomes. A 1:1 propensity score matching (PSM) algorithm was applied to adjust for baseline differences and validate the results.
Ergebnisse
A total of 226 patients met the inclusion criteria: 74 in Group I and 152 in Group II. The median follow-up duration was 49 months (IQR: 28–64 months), with no significant difference between the groups. Group I had a significantly higher incidence of 30-day MACE (8.2% vs. 1.99%, p=0.026) and mortality (9.46% vs. 0.66%, p=0.001). Other early complications and LOS were comparable between groups. Multivariable analysis identified age ≥80 years as an independent predictor of MACE (OR 5.83, p=0.020) and 30-day mortality (OR 24.61, p=0.005). However, Kaplan-Meier estimates showed no significant differences in overall survival, freedom from AAA-related death, or re-intervention rates at 2 years between the groups. After PSM, the groups were well-balanced, but octogenarians still had higher rates of MACE (6.8% vs. 0%, p=0.047) and 30-day mortality (9.59% vs. 0%). Overall survival, and re-intervention rates remained comparable during follow-up.
Schlussfolgerung
Octogenarians undergoing open repair for cAAA had a significantly higher risk of 30-day mortality and MACE compared to younger patients. However, mid-term outcomes—including survival and re-intervention rates—were not significantly affected by age. These findings support open surgical repair as a durable treatment option, even in elderly patients.