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Surgical and medical treatments of true and dissecting aortic aneurysm in cases over 65 years old.

Ninety-one patients with true and dissecting aortic aneurysm were reviewed. They ranged in age from 65 to 87 years (mean 71 years). Forty-eight patients were diagnosed with abdominal aortic aneurysm, 21 patients with thoracic aortic aneurysm and 22 patients with dissecting aortic aneurysm. They were divided into 2 categories, surgical group and non-surgical, and the prognoses of the 2 groups were compared. The average age of surgically treated cases was significantly younger than that of non-surgical cases. This study suggests that elective operation should be considered for abdominal aortic aneurysms because of the high risk of late rupture. In older patients with thoracic aortic aneurysm, the prognosis was better in surgically treated patients than in those not treated. However, the surgical mortality rate of elective operation was high. The surgical mortality rate of older patients with dissecting aortic aneurysm was not satisfactory, and medical treatment which decreases blood pressure should be considered first. All patients classified as Stanford type A should be operated on if possible.