Abstract
This report describes 3 aged patients undergoing emergent surgery who refused elective operation for a thoracic aortic aneurysm because of freedom from symptoms attributable to the aneurysm at the time of presentation. A 77-year-old women with a thoracoabdominal aneurysm 57 mm in diameter at presentation had recurrent hemoptysis 12 months later. A 78-yar-old man with a saccular type distal arch aneurysm 64 mm in diameter at presentation was transported with shock and hemothorax 27 months later. Another 82-year-old man with a saccular type distal arch aneurysm 60 mm in diameter at presentation was admitted with severe chest and back pain 36 months later. All of them underwent tube graft replacements of the aneurysm urgently and were discharged on foot. Aged patients with life-threatening events should not be denied surgical intervention because of excessive operative mortality and morbidity, even if they had previously refused elective surgery.
Similar content being viewed by others
References
Neri E, Toscano T, Massetti M, Capannini G, Carone E, Tucci E, et al. Operation for acute type A aortic dissection in octogenarians: Is it justified? J Thorac Cardiovasc Surg 2001; 121: 259–67.
Okita Y, Ando M, Minatoya K, Tagusari O, Kitamura S, Nakajima N, et al. Early and long-term results of surgery for aneurysms of the thoracic aorta in septuagenarians and octogenarians. Eur J Cardio-thorac Surg 1999; 16: 317–23.
Takamoto S, Matsuda T, Harada M, Miyata S, Shimamura Y. Simple hypothermic retrograde cerebral perfusion during aortic arch replacement: A preliminary report on two successful cases. J Thorac Cardiovasc Surg 1992; 104: 1106–9.
Cambria RA, Gloviczki P, Stanson AW, Cherry KJ Jr, Bower TC, Hallett JW Jr, et al. Outcome and expansion rate of 57 thoracoabdominal aortic aneurysms managed nonoperatively. Am J Surg 1995; 170: 213–7.
Davies RR, Goldstein LJ, Coady MA, Tittle SL, Rizzo JA, Kopf GS, et al. Yearly rupture or dissection rates for thoracic aortic aneurysms: Simple prediction based on size. Ann Thorac Surg 2002; 73: 17–28.
Kouchoukos NT, Dougenis D. Surgery of the thoracic aorta. N Engl J Med 1997; 336: 1876–88.
Kozai Y, Watanabe S, Yonezawa M, Itani Y, Inoue T, Takasu J, et al. Long-term prognosis of acute aortic dissection with medical treatment: A survey of 263 unoperated patients. Jpn Circ J 2001; 65: 359–63.
Perko MJ, Norgaard M, Herzog TM, Olsen PS, Schroeder TV, Pettersson G. Unoperated aortic aneurysm: A survey of 170 patients. Ann Thorac Surg 1995; 59: 1204–9.
Goldstein LJ, Davies RR, Rizzo JA, Davila JJ, Cooperberg MR, Shaw RK, et al. Stroke in surgery of the thoracic aorta: Incidence, impact, etiology, and prevention. J Thorac Cardiovasc Surg 2001; 122: 935–45.
Kawachi Y, Toshima Y, Nakashima A, Arinaga K, Komesu I. Emergency surgery results in life-threatening thoracic aortic disease. Jpn J Thorac Cardiovasc Surg 2002; 50: 158–64.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kawachi, Y., Nakashima, A., Toshima, Y. et al. Emergent surgery for 3 aged patients who refused elective operation for thoracic aortic aneurysm. Jpn J Thorac Caridovasc Surg 51, 438–441 (2003). https://doi.org/10.1007/BF02719598
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02719598