INTRODUCTION
Acute type A aortic dissection (ATAAD) is a serious and lethal
cardiovascular event, and surgical repair is essential to help these
patients.1 Old age is a risk factor for in-hospital
mortality in cardiovascular surgery,2 and according to
the data of The International Registry of Acute Aortic Dissection
(IRAD), age ≥70 years is a significant predictor of in-hospital surgical
mortality in ATAAD.3 In contrast, it has been reported
that octogenarian patients showed satisfactory surgical outcomes and
survival rates, which suggests a confident approach toward emergency
repair in elderly patients.4 Physical activities are
important prognostic factors for late mortality in elderly patients with
cardiovascular disease.5 Cassiatore et al reported
that walking ability is strongly related to mortality and morbidity in
elderly patients after cardiac coronary artery bypass
grafting.6 However, there are few studies that
investigated the rehabilitation outcomes and postoperative physical
activities for ATAAD in elderly patients.7, 8 The
specific types and intensities of rehabilitation that may be both safe
and beneficial postoperatively for patients who underwent ATAAD is still
controversial.7
We report our experience with ATAAD surgery in patients aged ≧70. The
outcomes of our rehabilitation program based on walking exercise and the
surgical outcomes of ATAAD repair in these patients were compared with
those in patients aged <70 years. We also assessed how
postoperative physical activities impact late mortality in the patients
with ATAAD.