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 long-term 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.