Mid- and long-term outcomes of thoracic endovascular aortic repair in acute and subacute uncomplicated type B aortic dissection

Matti Jubouri, Mohammed Al-Tawil, Ho Cheung Anthony Yip, Ali Bashir, Sven Zhen Cian Patrick Tan, Mohamad Bashir, Richard Anderson, Damian Bailey, Christoph A. Nienaber, Joseph S. Coselli, Ian Williams

Allbwn ymchwil: Cyfraniad at gyfnodolynErthygladolygiad gan gymheiriaid

Crynodeb

BACKGROUND: Uncomplicated type B aortic dissection (un-TBAD) has been managed conservatively with medical therapy to control the heart rate and blood pressure to limit disease progression, in addition to radiological follow-up. However, several trials and observational studies have investigated the use of thoracic endovascular aortic repair (TEVAR) in un-TBAD and suggested that TEVAR provides a survival benefit over medical therapy. Outcomes of TEVAR have also been linked with the timing of intervention.

AIMS: The scope of this review is to collate and summarize all the evidence in the literature on the mid- and long-term outcomes of TEVAR in un-TBAD, confirming its superiority. We also aimed to investigate the relationship between the timing of TEVAR intervention and results.

METHODS: We carried out a comprehensive literature search on multiple electronic databases including PubMed, Scopus, and EMBASE to collate and summarize all research evidence on the mid- and long-term outcomes of TEVAR in un-TBAD, as well as its relationship with intervention timing.

RESULTS: TEVAR has proven to be a safe and effective tool in un-TBAD, offering superior mid- and long-term outcomes including all-cause and aorta-related mortality, aortic-specific adverse events, aortic remodeling, and need for reintervention. Additionally, performing TEVAR during the subacute phase of dissection seems to yield optimal results.

CONCLUSION: The evidence demonstrating a survival advantage in favor TEVAR over medical therapy in un-TBAD means that with further research, particular trials and observational studies, TEVAR could become the gold-standard treatment option for un-TBAD patients.

Iaith wreiddiolSaesneg
Rhif yr erthygl16349
Tudalennau (o-i)1328-1339
Nifer y tudalennau12
CyfnodolynJournal of Cardiac Surgery
Cyfrol37
Rhif cyhoeddi5
Dyddiad ar-lein cynnar21 Chwef 2022
Dynodwyr Gwrthrych Digidol (DOIs)
StatwsCyhoeddwyd - Mai 2022

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