Descending thoracic aortic repair outcomes for chronic aortic dissection: a single-centre experience

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Medical Devices

Background:

• Chronic aortic dissection poses significant risks.
• Thoracic endovascular aortic repair (TEVAR) is an alternative to open surgery.
• Evaluating TEVAR's efficacy in chronic aortic dissection is crucial.

Purpose of the Study:

• To assess early and long-term outcomes of TEVAR for chronic aortic dissection.
• To compare TEVAR results with historical open surgical repair data.
• To identify predictors of adverse events in TEVAR.

Main Methods:

• Retrospective analysis of 492 patients undergoing TEVAR for chronic aortic dissection (2012-2020).
• Follow-up duration median 3.2 years.
• Multivariable analysis to identify risk factors for early major adverse events.

Main Results:

• Early mortality was 2.0%, stroke 3.5%, and spinal cord injury 6.1%.
• Age >70 and non-elective surgery predicted adverse events.
• Low-risk patients had excellent outcomes: 0.4% mortality, 1.5% stroke, 0.4% spinal cord injury.

Conclusions:

• TEVAR demonstrates favorable early and long-term results for chronic aortic dissection.
• It is a viable gold standard treatment, especially for low-risk patient cohorts.
• Risk stratification is important for optimizing TEVAR outcomes.