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Decreased biventricular function following thoracic endovascular aortic repair
Maximilian Kreibich1, Julia Morlock1, Friedhelm Beyersdorf1
1Department of Cardiovascular Surgery, Faculty of Medicine, University Heart Center Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
Interactive Cardiovascular and Thoracic Surgery
|December 19, 2019
Summary
Thoracic endovascular aortic repair (TEVAR) may lead to negative cardiac remodeling, indicated by reduced heart function. Increased antihypertensive medication use post-TEVAR highlights the need to consider graft stiffness effects.
Area of Science:
- Cardiovascular Medicine
- Medical Engineering
- Aortic Disease Research
Background:
- Preclinical studies indicate thoracic endovascular aortic repair (TEVAR) can cause acute aortic stiffening.
- This aortic stiffening may lead to elevated pulse pressure, hypertension, and potential heart failure.
Purpose of the Study:
- To evaluate cardiac remodeling following thoracic endovascular aortic repair (TEVAR).
- To assess changes in cardiac function and medication use after TEVAR.
Main Methods:
- Retrospective analysis of 519 TEVAR procedures performed between 2005 and 2018.
- Transthoracic echocardiography pre- and post-TEVAR in 31 patients.
- Evaluation of patient characteristics, medication, and follow-up data; aortic measurements via multiplanar reconstruction.
Main Results:
- Echocardiography 2 years post-TEVAR showed reduced left ventricular ejection fraction and tricuspid annular plane systolic excursion.
- Patients required significantly more antihypertensive drugs post-TEVAR.
- No significant increase in left ventricular mass was detected.
Conclusions:
- TEVAR is associated with negative cardiac remodeling and decreased ventricular function, even with increased antihypertensive medication.
- The impact of stiffer endovascular grafts compared to the native aorta warrants consideration by specialists and manufacturers.
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