Original articleAdult cardiacType A Aortic Dissection After Thoracic Endovascular Aortic Repair
Section snippets
Patients and Methods
We retrospectively reviewed details from the medical records of 546 patients (mean age, 70 ± 11 years; 409 men and 137 women) with diseases of the thoracic aorta (thoracic aortic aneurysm, n = 362; aortic dissection, n = 178; and fistula between the descending thoracic aorta and esophagus, n = 6) who underwent TEVAR in five hospitals from May 1997 to February 2015, to identify patients in whom TAAD developed during or after TEVAR. Among 178 patients with aortic dissection, 18 had de novo acute
Results
In 12 patients (2.2%, 12 of 546; mean age 70 ± 8 years; 7 men, 5 women), TAAD developed during or after TEVAR. Ten patients had undergone TEVAR for the treatment of aortic dissection (5.6%, 10 of 178), whereas the remaining 2 patients had undergone TEVAR for the treatment of other thoracic aortic diseases (0.5%, 2 of 368; p = 0.00 versus aortic dissection; Table 1). Among patients who had undergone TEVAR for aortic dissection, 3 (16.7%, 3 of 18) had undergone TEVAR for de novo acute retrograde
Comment
Development of TAAD after TEVAR is one of the most catastrophic events associated with TEVAR, with a reported incidence in the range of 1.3% to 6.8% in previous studies 8, 9, 10, 11. Patients who underwent TEVAR for the treatment of aortic dissection were more prone to have TAAD [8] and accounted for 83% of all patients (10 of 12) who had TAAD in our series. From the point of original aortic pathology, the frequency of TAAD was 5.6% among patients who underwent TEVAR for the treatment of aortic
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