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Optimal blood pressure control for patients after thoracic endovascular aortic repair of type B aortic dissection

Nan Lu1, Xiaojing Ma2, Tan Xu1

  • 1Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, Guangdong, 515041, People's Republic of China.

BMC Cardiovascular Disorders
|May 29, 2019
PubMed

Insights

A systolic blood pressure (SBP) of 130 mmHg at discharge is optimal for predicting short-term adverse events in type B aortic dissection (BAD) patients after thoracic endovascular aortic repair (TEVAR). Patients with hybrid operations or multiple stents require closer blood pressure monitoring.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Current guidelines recommend strict systolic blood pressure (SBP) control for type B aortic dissection (BAD) patients, but an optimal SBP threshold remains undefined.
  • This study addresses the need for a specific SBP cut-off value to optimize outcomes in BAD patients post-thoracic endovascular aortic repair (TEVAR).

Purpose of the Study:

  • To determine the optimal systolic blood pressure (SBP) cut-off value for predicting short-term adverse events in patients with type B aortic dissection (BAD) following thoracic endovascular aortic repair (TEVAR).

Main Methods:

  • A cohort of 269 consecutive patients with BAD after TEVAR were analyzed.
  • Systolic blood pressure (SBP) at discharge was assessed as a predictor of 90-day aortic-related adverse events (ARAE) using Cox regression.
  • Receiver operator curve analysis identified the optimal SBP cut-off value.

Main Results:

  • A systolic blood pressure (SBP) cut-off of 130 mmHg at discharge was identified as optimal for predicting 90-day aortic-related adverse events (ARAE).
  • Higher SBP at discharge was significantly associated with increased 90-day ARAE (HR 3.780; p=0.020).
  • Hybrid operations (OR 2.046; p=0.045) and the use of ≥2 stents (OR 2.950; p=0.022) were independently associated with SBP > 130 mmHg.

Conclusions:

  • An SBP of 130 mmHg at discharge serves as an effective threshold for predicting short-term adverse events in type B aortic dissection (BAD) patients post-TEVAR.
  • Increased attention to blood pressure management is warranted for patients undergoing hybrid operations or requiring multiple stents.
Abstract

Keywords:
Aortic related adverse eventsOptimal blood pressureThoracic endovascular aortic repairType B aortic dissection

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