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Endovascular Treatment for Nontraumatic Rupture of the Descending Thoracic Aorta: Long‐Term Results
Author(s) -
Botsios Spiridon,
Frömke Johannes,
Walterbusch Gerhard,
Schuermann Karl,
Reinstadler Jan,
Dohmen Guido
Publication year - 2014
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12329
Subject(s) - medicine , thoracic aorta , surgery , descending aorta , mortality rate , aortic rupture , aorta , pneumonia , aortic dissection , retrospective cohort study , dissection (medical) , radiology , aortic aneurysm
Abstract Background This study evaluated the long‐term results of thoracic endovascular aortic repair (TEVAR) of nontraumatic rupture of the descending thoracic aorta. Methods This was a retrospective and observational single‐center study. During the 10‐year study period, 21 patients (6 males) with an average age of 66.1 ± 12.4 (range 31–81) years underwent emergency TEVAR for nontraumatic rupture of the descending thoracic aorta. The underlying aortic pathologies causing the rupture were degenerative aneurysms in 11 patients, complicated type B dissection in nine, and erosion hemorrhage due to neoplasia in one patient. Results The 30‐day mortality rate was 9.5% (2/21). Two patients died postoperatively: one from a repeat aortic rupture and the other from pneumonia. Two patients underwent early endovascular reintervention. After a median follow‐up of 65.6 ± 50.4 (range 1.5–44) months, 10 patients died, resulting in a late mortality of 52.6% (10/19). Six patients (31.5%) developed major complications requiring late reintervention. There was no mortality with reintervention. Conclusions Endovascular treatment of the descending thoracic aorta in patients with nontraumatic rupture is a promising treatment option in an emergency setting with a relatively low mortality rate. Despite encouraging early results, TEVAR is associated with a high reintervention rate and poor survival due to nonaortic or procedure‐related mortality in the long term. doi: 10.1111/jocs.12329 (J Card Surg 2014;29:353–358)