Operative details and complications
Operative details and complications are shown in Table 2. Ascending aortic replacement was more likely in the elderly group (P = 0.065). Arch replacement was less likely in the elderly group, but there was no statistically significant difference (P = 0.091). There was no significant difference in aortic root replacement, concomitant aortic valve replacement, and coronary artery bypass grafting between the groups. Because of more ascending aortic replacement and less arch replacement in the elderly group, pump run time, aortic cross-clamp time, and operation time were significantly lower in the elderly group (pump run time: P < 0.001; aortic cross-clamp time:P = 0.003; operation time: P < 0.001).
Among postoperative complications, stroke, pneumonia, mediastinitis, intestinal ischemia, long-term intubation (>3 weeks), and re-exploration for bleeding were not significantly different between the groups. Frequency of postoperative temporary or permanent hemodialysis were significantly lower in patients in the elderly group (P = 0.015). Postoperative dysphagia occurred significantly more frequently in elderly patients (P = 0.017). ICU stay was likely to be longer in the elderly group (P = 0.094); hence, the duration of hospitalization was significantly longer in the elderly group (P= 0.045). Elderly patients with ATAAD surgery were more likely to decrease their walking ability at discharge because they were significantly less likely to discharge by walking without any aids (P = 0.021) and more likely to discharge with a wheelchair compared with patients in the control group (P = 0.052). Postoperative walking difficulty was significantly more advanced in the elderly group (P = 0.013); therefore, the Barthel index for the elderly group on discharge was significantly lower than the control group (P = 0.032).