Ninety Days Mortality after Thoracic
Endovascular Aortic Repair
Kasana Raksamani MD*,
Pornsiri Wannadilok MD*, Worawong Slisatkorn MD**
Affiliation :
* Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : The thoracic endovascular aortic repair (TEVAR) has become popular due to its favorable immediate outcome.
However, the outcome in longer duration is still questionable. The aim of the present study was to analyze the incidence
and risk factors associated with 90 days mortality after TEVAR.
Material and Method: After the Siriraj Institutional Review Board, Thailand approved and waived the need for the informed
consent, the database that included 160 consecutive patients having TEVAR procedures between December 2006 and
December 2010 was examined. Patients’ characteristics, including operative procedures and anesthesia techniques were
studied. The mortality and complications were extracted and analyzed. Major adverse events and the others factors were
analyzed to determine the risk factors. Other complications such as bleeding, endoleak, infection, and reintervention were
examined and analyzed.
Results : One hundred sixty patients underwent TEVAR. They included 118 male (74%) and 42 female (26%) with mean age
of 65. Perioperative mortality (within 24 hours postoperatively) was 1(0.6%), 30 days mortality was 7 (4.4%) and the overall
90 days mortality was 10 (6.25%). Causes of death included sepsis [4 patients (2.5%)], multi-organ failure [3 patients
(1.9%)], ischemic heart disease [1 patient (0.6%)], uncontrolled bleeding [1 patient (0.6%)], and graft ruptured [1 patient
(0.6%)]. The risk factor related to mortality was postoperative neurological morbidity (OR 6.77, 95% CI = 1.08-42.36,
p = 0.4). General anesthesia with endotracheal tube was used in the majority of the patients (92.5%), with no statistical
significance in anesthesia-related mortality. Major adverse events including pneumonia 11.9%, cardiac arrhythmia 11.3%,
graft infection 7.5%, neurological complication 7.0% (ischemic stroke 9 and paraplegia 1), renal failure 3.8%, and myocardial
ischemia 0.6%.
Conclusion : The incidence of 90 days mortality after TEVAR was 6.25% (10 from 160). The risk factor associated with
mortality was the development of neurologic complication postoperatively.
Keywords : Mortality, Endovascular, Aorta, Stent
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