Abstract
We report a case of an extremely elderly patient with Stanford A acute aortic dissection who underwent successful graft replacement of the ascending aorta. The patient was a 95-year-old woman, capable of everyday independent activity. She had sudden loss of consciousness at mealtime. She visited a clinic where a chest X-ray showed abnormalities, and was then transferred to our hospital. Computed tomography scan revealed aortic dissection with cardiac tamponade. Emergency surgery was performed to save her life. Although the postoperative course was not problem-free, patient entered remission on day 77 following admittance and was subsequently moved to another hospital for rehabilitation.
Stanford type-A acute aortic dissection has a high degree of urgency and severity with poor prognosis if managed conservatively in patients whom surgery is indicated. Even with current stable surgical techniques, the likelihood of excessive surgical stress remains unchanged, with varied opinions on the legitimacy of applying such techniques to elderly patients. Recently, however, with the intention of performing entry closure, a number of studies have focused on avoiding extended surgery, aiming to perform less invasive surgery. This is thought to be of particular use in performing life-saving surgery on elderly patients.
