Document Detail

Risk factors of mortality in different age groups after thoracic endovascular aortic repair.
MedLine Citation:
PMID:  20667346     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this study was to determine risk factors for mortality in different age groups after thoracic endovascular aortic repair (TEVAR). METHODS: We retrospectively analyzed 226 consecutive patients undergoing TEVAR at our institution during a 12-year period (female 28%; median age 67 years). Fifty-six patients were more than 75 years of age at the time of TEVAR. Follow-up data were available in all patients. RESULTS: Patients more than 75 years old had a higher incidence of extracardiac arteriopathy (79% versus 58%; p = 0.006) and were more likely to be unsuitable for open surgery (84% versus 47%; p < 0.001). Multivariate logistic regression analysis revealed the combined endpoint of perioperative myocardial infarction and neurologic injury (p = 0.023, odds ratio 13.9, 95% confidence interval: 1.44 to 134.6) as well as persisting type I and III endovascular leaks (p = 0.042, odds ratio 2.81, 95% confidence interval: 1.04 to 7.58) as independent predictors of mortality in patients less than 75 years old. Emergency TEVAR was the only independent predictor of mortality among patients more than 75 years old (p = 0.041, odds ratio 3.65, 95% confidence interval: 1.06 to 12.64). CONCLUSIONS: Different age groups exhibit different risk factors after TEVAR. The prognosis for younger patients is substantially limited by perioperative myocardial infarction and neurologic injury as well as persisting endovascular leak formation, as these patients may be more likely to experience aortic-related complications. Emergency TEVAR-most often being associated with hemodynamic instability-is the limiting factor for elderly patients, reflecting their frail physiology. Adhering to strict indications and broad screening, thereby reducing the incidence of emergency procedures, will help to further improve outcome after TEVAR.
Martin Czerny; Martin Funovics; Marek Ehrlich; Michael Hoebartner; Gottfried Sodeck; Julia Dumfarth; Maria Schoder; Andrzej Juraszek; Tomasz Dziodzio; Christian Loewe; Daniel Zimpfer; David Reineke; Michael Grimm
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  534-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland.
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MeSH Terms
Age Factors
Aorta, Thoracic / surgery*
Aortic Diseases / mortality*,  surgery*
Postoperative Complications / epidemiology
Retrospective Studies
Risk Factors
Thoracic Surgical Procedures / adverse effects,  methods
Vascular Surgical Procedures / adverse effects,  methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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