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Risk Factors of Early and Late Mortality After Thoracic Endovascular Aortic Repair for Complicated Stanford B Acute Aortic Dissection
Author(s) -
Ruan ZhongBao,
Zhu Li,
Yin YiGang,
Chen GeCai
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.12377
Subject(s) - medicine , cardiology , aortic dissection , hazard ratio , myocardial infarction , cardiac tamponade , mortality rate , surgery , proportional hazards model , aorta , confidence interval
Abstract Background and Aim of the Study The risk factors associated with death in complicated Stanford B acute aortic dissection (AAD) after thoracic endovascular aortic repair (TEVAR) are poorly understood. The aim of this study was to evaluate the early and late events and mortality of complicated Stanford B AAD associated with TEVAR. Methods Sixty‐two patients with complicated Stanford B AAD undergoing TEVAR were included in this study. Results Primary technical success of TEVAR was achieved in 61 (98.39%) cases. The early mortality rate was 9.68%. Procedural type I endoleak (p = 0.007, OR = 7.71, 95% CI: 1.75–34.01) and cardiac tamponade (p = 0.010, OR = 8.86, 95% CI: 1.70–4 6.14) were the significant predictors of early death in the multivariate model. The late mortality was 16.07%. Cox regression analysis revealed rupture of false lumen (p = 0.001, hazard ratio = 21.96, 95% CI: 3.02–82.12), postoperative myocardial infarction (p = 0.001, hazard ratio = 9.86, 95% CI: 2.12–39.64), and acute renal failure (p = 0.024, hazard ratio = 3.98, 95% CI: 1.26–12.11) to be independent risk factors of late mortality. Conclusions Type I procedural endoleak and cardiac tamponade were the significant predictors of early death in patients of complicated Stanford B AAD undergoing TEVAR. Rupture of false lumen, postoperative myocardial infarction, and acute renal failure were the independent risk factors for late death after TEVAR. doi: 10.1111/jocs.12377 (J Card Surg 2014;29:501–506)