Role of CTA Surveillance for Management of Endovascular Repair of Aortic Dissection

Authors

  • Brandon Sloan, MS College of Medicine, Medical University of South Carolina, Charleston, SC, USA
  • Anna Lena Emrich, MD Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center Mainz, Germany
  • Marc Katz, MD Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA
  • U. Joseph Schoepf, MD Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
  • Tilman Emrich, MD Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
  • Sanford Zeigler, MD Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA

DOI:

https://doi.org/10.1532/hsf.4489

Keywords:

Computed Tomography, Aortic Dissection, TEVAR, Follow-up, Outcome

Abstract

Objectives: The aim of this study was to evaluate the effect of timing for post-interventional CT imaging on the rate of re-intervention and all-cause mortality in patients with endovascular treatment of type B aortic dissections (TBAD).

Material and methods: Data on 70 patients with endovascular repair of aortic dissection during a three-year period from a single institution retrospectively were collected. Study participants were stratified based on those who had a postoperative CTA in the first 30 days after index intervention (early) vs. those who did not (late). The re-intervention and all-cause mortality rates between the two groups were investigated using Kaplan-Meier and Cox regression analysis.

Results: During a median follow-up time of 230 days, the primary endpoint (additional operation) was reached in 24/70 patients (34.3%) with no statistically significant difference between the early and late CTA group (log-rank-test: P = 0.886). All-cause mortality was present in 14/70 (20%) patients, with no statistically significant difference between both groups (log-rank-test: P = 0.440). Additionally, both groups had no significant differences in time to additional operation and death. Cox regression analysis revealed the presence of a chronic TBAD and underlying connective tissue disease as relevant risk factors for the need for an additional operation and obesity as a protective and renal failure as a negative factor for all-cause mortality.

Conclusion: CTA surveillance within 30 days of the index operation did not significantly modify mortality or rate of re-intervention after endovascular treatment for TBAD. Surveillance recommendations should be tailored to individualized factors.

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Published

2022-06-20

How to Cite

Sloan, B., Emrich, A. L., Katz, M., Schoepf, U. J., Emrich, T., & Zeigler, S. (2022). Role of CTA Surveillance for Management of Endovascular Repair of Aortic Dissection. The Heart Surgery Forum, 25(3), E441-E448. https://doi.org/10.1532/hsf.4489

Issue

Vol. 25 No. 3 (2022)

Section

Article
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