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

Research output: Contribution to journalArticlepeer-review

38 Downloads (Pure)

Abstract

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.

Original languageEnglish
Article number16349
Pages (from-to)1328-1339
Number of pages12
JournalJournal of Cardiac Surgery
Volume37
Issue number5
Early online date21 Feb 2022
DOIs
Publication statusPublished - May 2022

Keywords

  • aortic dissection
  • aortic surgery
  • TEVAR
  • Type B aortic dissection

Fingerprint

Dive into the research topics of 'Mid- and long-term outcomes of thoracic endovascular aortic repair in acute and subacute uncomplicated type B aortic dissection'. Together they form a unique fingerprint.

Cite this