Mid-term outcomes of thoracic endovascular aortic repair for complicated type B aortic dissection

Patients and methods:This retrospective study included a total of 29 consecutive patients (27 males, 2 females; mean age 61.1±11.8 years; range, 34 to 80 years) who underwent TEVAR due to complicated type B aortic dissection at our center between March 2015 and December 2018. All pre-, intra-, and postoperative data were collected. Surgical and discharge notes were reviewed.

Results: Of the patients, 27 had hypertension and seven had coronary artery disease. The mean maximum aortic diameter was 50.5±7.7 mm. Suspicion of impending rupture was the most (n=13) associated complication with type B aortic dissection. Six patients (20.7%) had rupture and 10 patients (34.5%) had uncontrolled hypertension. The procedure was performed under elective conditions in 18 patients (62.1%) and under emergency setting in 11 patients (37.9%). Early mortality was developed in one patient (3.4%) due to low cardiac output syndrome. The mean follow-up was 25±11 months. Late mortality occurred in two patients (6.9%) due to lung cancer and sepsis. The overall survival rate was 86.1±9.8% and freedom from aortic re-intervention was 88.8±7.5% at 50 months.

Conclusion: Our study results show that TEVAR is a safe procedure associated with good postoperative outcomes, and outstanding mid-term results in complicated type B aortic dissection.