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. 2022 Aug;52(8):1194-1201.
doi: 10.1007/s00595-021-02443-x. Epub 2022 Jan 4.

Impact of frailty on early and mid-term outcomes of hybrid aortic arch repair

Yuichiro Kishimoto  1 , Yasushi Yoshikawa  2 , Kenichi Morimoto  1 , Takeshi Onohara  1 , Hiromu Horie  1 , Kunitaka Kumagai  1 , Rikuto Nii  1 , Motonobu Nishimura  1
Affiliations

Impact of frailty on early and mid-term outcomes of hybrid aortic arch repair

Yuichiro Kishimoto et al. Surg Today. 2022 Aug.

Abstract

Purpose: The purpose of this study was to investigate the impact of frailty on the clinical outcomes of hybrid aortic arch repair with debranching of the supra-aortic arteries.

Methods: Consecutive patients ≥ 75 years old who underwent hybrid aortic arch repair from January 2010 to December 2019 were retrospectively analyzed. Using the Canadian Study of Health and Aging (CSHA) scale, all patients with a CSHA scale score > 4 were defined as frail. The frail patients (FP) group and the non-frail patients (NFP) group were compared regarding the early and mid-term outcomes of hybrid aortic arch repair.

Results: A total of 84 patients were included. The early postoperative results were not markedly different between the groups, except that the rate of transfer to a rehabilitation hospital was higher in the FP group than in the NFP group. The survival at 5 years was significantly lower in the FP group at 43.0% than in the NFP group at 67.7% (P = 0.015). However, the freedom from aorta-related death was not significantly different between the two groups.

Conclusion: Frailty did not affect the short-term outcomes of hybrid aortic arch repair; however, the mid-term outcomes, including the survival, of the frail patients were significantly worse than those of the non-frail patients, mostly because of non-aorta-related causes.

Keywords: Aortic arch; Debranching; Frailty; Hybrid repair; Thoracic aneurysm.

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