Zone 2/3 lesion and emergency repair as potential mortality predictors of TEVAR for thoracic aortic pseudoaneurysm

Zone 2/3 lesion and emergency repair as potential mortality predictors of TEVAR for thoracic aortic pseudoaneurysm

Abstract Objective Thoracic aortic pseudoaneurysm (TAP) is an uncommon but life-threatening condition. The present study aimed to investigate the early and midterm clinical outcome of TAP patients following TEVAR and identify potential mortality predictors. Methods We retrospectively reviewed a seri...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2023-10, Vol.18 (1), p.1-299, Article 299
Main Authors: Wang, Hui, Shu, Chang, Wang, Tun, He, Hao, Li, Xin, Li, Quanming, Peng, Yuan, Wang, Lunchang, Sun, Likun
Format: Article
Language:eng
Subjects:
Antibiotics
Aorta
Aortic pseudoaneurysm
Aortoesophageal fistula
Atherosclerosis
Coronary vessels
Drugs
Embolism
Esophagus
Etiology
Foreign bodies
Implants
Infections
Ischemia
Lesions
Local anesthesia
Medical imaging
Mortality
Ostomy
Patients
Pseudoaneurysm
Pulmonary arteries
Surgery
Systemic vasculitis
Thoracic endovascular aortic repair
Thorax
Trauma
Veins & arteries
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Summary:Abstract Objective Thoracic aortic pseudoaneurysm (TAP) is an uncommon but life-threatening condition. The present study aimed to investigate the early and midterm clinical outcome of TAP patients following TEVAR and identify potential mortality predictors. Methods We retrospectively reviewed a series of 37 eligible patients with TAP admitted to our hospital from July 2010 to July 2020. We explored their baseline, perioperative and follow-up data. Fisher exact test and Kaplan–Meier method were applied for comparing difference between groups. Results There were 29 men and 12 women, with the mean age as 59.5 ± 13.0 years (range 30–82). The mean follow-up period was 30.7 ± 28.3 months (range 1–89). For early outcome (≤ 30 days), mortality happened in 3 (8.1%) zone 3 TAP patients versus 0 in zone 4 ( p = 0.028); postoperative acute arterial embolism of lower extremity and type II endoleak respectively occurred in 1(2.7%) case. For midterm outcome, survival at 3 months, 1 year and 5 years was 88.8%, 75.9% and 68.3%, which showed significant difference between zone 2/3 versus zone 4 group (56.3% vs. 72.9%, p = 0.013) and emergent versus elective TEVAR group (0.0% versus 80.1%, p = 0.049). Previous stent grafting or esophageal foreign body with Aortoesophageal fistula (AEF), and systemic vasculitis, as etiologies, resulted in encouraging immediate outcome but worse midterm prognosis. Conclusion TAP lesions at zone 2/3 and emergent TEVAR predict worse midterm outcomes compared to zone 4 lesions and elective TEVAR. The outcomes are also mainly restricted by the etiology of the TAP.
ISSN:1749-8090
1749-8090