Abstract 19075: TEVAR Remodels the Thoracic and Abdominal Aorta in Acute DeBakey 3 Dissection: Early Results
Introduction: The objective of this study was to determine the remodeling impact of TEVAR on different segments of the aorta in acute DeBakey 3 aortic dissections.
Methods: Between January 2012 and June 2014, 136 patients underwent TEVAR at a US academic institution. 32 (24%) patients underwent TEVAR for acute complicated DeBakey 3 (3a n=3, 3b n=29) aortic dissections. Volumetric measurements of the true and false lumens of the descending thoracic and abdominal aorta were performed upon pre and postoperative CT scans using Osirix Imaging Software. Aortic volumes were measured for the stented, stent end to celiac artery, celiac to renals, and infrarenal aortic segments. True lumen (TLR= true lumen (TL)/total aortic volume) and false lumen ratios (FLR=false lumen(FL)/total aortic volume) were calculated using total aortic volumes.
Results: The mean age was 56 ± 12 years. The mean length of aortic coverage was 197±29 mm. Operative mortality was 3.1%. The incidence of stroke and transient paraperesis were 3.1%. There were no cases of new post-op paraplegia. All 3a patients had complete thrombosis of the FL. At a mean follow up of 8±6 months, 11 (60%) 3b patients had complete thrombosis of the FL along the length of the stent. 5 patients experienced FL thrombosis at 1 month follow up, and 6 thrombosed between 3 and 12 months. The TLR significantly increased and the FLR was significantly reduced at 1 month following TEVAR (Pre TLR 29.1% vs Post TLR 45.8%, pre FLR 70.9% vs Post FLR 54.2%, p<0.001). Aortic remodeling continued with persistent expansion of the TL at 6 months (TLR 54.6%). Significant segmental aortic remodeling was observed in both stented and non-stented regions of the thoracic and abdominal aorta (Table).
Conclusions: Significant aortic remodeling is observed immediately following TEVAR in both stented and non-stented regions of the thoracic and abdominal aorta. Aortic remodeling and FL thrombosis continues to occur at 12 months following TEVAR.
Author Disclosures: B.G. Leshnower: Speakers Bureau; Modest; Medtronic. Honoraria; Modest; St Jude’s Medical, Cryolife. C. Li: None. Y.M. Duwayri: Honoraria; Modest; Cook Medical. T.S. Henry: None. E.P. Chen: Honoraria; Modest; Cryolife. R.K. Veeraswamy: Honoraria; Modest; Cook Medical, Medtronic.
- © 2014 by American Heart Association, Inc.