Abstract 19062: Outcomes of Patients with Acute Type B (DeBakey III) Aortic Dissection: a 13 Year Single Center Experience
Introduction: Thoracic endovascular aortic repair (TEVAR) has emerged as a treatment option for patients with acute type B aortic dissection (ATBAD). The aim of this study is to evaluate the long-term outcomes of patients with ATBAD.
Methods: We reviewed patients with ATBAD between 2001 and 2014, analyzing patient variables, in-hospital complications and long-term outcomes based on status (complicated (c) vs uncomplicated (u)) and treatment modalities. Long term outcomes were analyzed using Kaplan-Meier and log-rank statistics.
Results: We treated 442 patients with ATBAD. Mean age was 60.5±14.1 and 165 (37.3%) females. Of these 292 (66.1%) had uATBAD and were treated medically, while 150 (33.9%) had cATBAD. Of the cATBAD patients 56 (37.3%) were treated medically, 52 (34.7%) with open surgery, 29(19.3%) with TEVAR, and 13 (8.7%) with other open vascular procedures. Hospital mortality and morbidity were significantly related to treatment group (table 1). Median follow-up time was 4.4 years (range 0-13.4). Intervention-free survival at 1 and 5 years was 85.5% and 68.2% for uATBAD; 60.5% and 49% for cATBAD-medical; 65.1% and 49.5% for cATBAD-open; 75% and 75% for cATBAD-TEVAR; p=0.005 . Long-term survival was significantly related to presentation as complicated dissection (Fig. 1)
Conclusions: In our experience, early and late outcomes of ATBAD were dependent on the presence of complicated status with complicated ATBAD faring worse. Although uncomplicated ATBAD was associated with favorable early survival, late complications still occurred mandating radiographic surveillance. Prospective trials will be required to better determine optimal therapy for uncomplicated ATBAD
Author Disclosures: R.O. Afifi: None. H.K. Sandhu: None. S.S. Leake: None. V. Kumar: None. A. Azizzadeh: Consultant/Advisory Board; Modest; Gore Associates, Medtronic. K.M. Charlton-Ouw: None. T.C. Nguyen: None. C.C. Miller: None. H.J. Safi: None. A.L. Estrera: None.
- © 2014 by American Heart Association, Inc.