Long-Term Outcomes in Patients Undergoing Thoracic Endovascular Aortic Repair. Single Center Experience

Background: To analyze long-term outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR). Methods: All consecutive 97 patients undergoing TEVAR between September 2014 and September 2022 were included in the study. The primary outcome was the longterm incidence of overall death and major adverse cardiovascular and cerebrovascular events (MACCE). Results: Mean age was 70.4 years, and 22 (23.2%) had cerebrovascular disease (CBVD). 49 (51.6%) patients had prior cardiac surgery intervention and 8 (8.5%) had prior aortic valve replacement. Twenty-eight patients (28.8%) presented with aortic dissection, 60 (61.8%) had aortic aneurysm, 4 (4.1%) had intramural hematoma, and 5 (5.1%) had other presentations. An emergent procedure was performed in 6 (6.2%) patients, an urgent procedure in 37 (38.1%) patients and 54 (55.7%) patients had an elective procedure. Intraoperatively, 78.3% had percutaneous TEVAR, 5.1% had ministernotomy TEVAR, while 10.3% had concomitant full sternotomy TEVAR repair. Hospital mortality occurred in 7 patients (7.2%). At 8-year follow-up, 76% were alive, 25.8% had MACCE, 21.6% were diagnosed with endoleaks (13 patients type II and 2 patients type 1) and 10.3% underwent repeat intervention. Conclusions: This single-center study found that patients undergoing TEVAR had good short- and long-term survival and MACCE. Despite almost half of the patients undergoing an urgent/emergent procedure, the clinical outcomes were favorable for TEVAR.