Thorac Cardiovasc Surg 2019; 67(S 01): S1-S100
DOI: 10.1055/s-0039-1678978
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Impact of Aortic Pathology on Stent-Graft-Induced Postimplantation Syndrome

L. Volevski
1   Department of Cardiac Surgery, University of Marburg, Marburg, Germany
,
B. T. Andrási
1   Department of Cardiac Surgery, University of Marburg, Marburg, Germany
,
M. Irqsusi
1   Department of Cardiac Surgery, University of Marburg, Marburg, Germany
,
M. Vondran
1   Department of Cardiac Surgery, University of Marburg, Marburg, Germany
,
S. Vogt
1   Department of Cardiac Surgery, University of Marburg, Marburg, Germany
,
N. Mirow
1   Department of Cardiac Surgery, University of Marburg, Marburg, Germany
,
A. Rastan
1   Department of Cardiac Surgery, University of Marburg, Marburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
28 January 2019 (online)

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Objectives: Postimplantation syndrome (PIS) after thoracic endovascular aortic repair (TEVAR) was shown to increase the risk of major adverse events, need for reintervention and all-cause mortality. However, the impact of aortic pathology on PIS has not yet been determined.

The aim of this study was to investigate the biomarker profile and the clinical impact of PIS after TEVAR for different aortic pathologies.

Methods: Fifty patients undergoing TEVAR for aortic dissection (AD, 21), aortic aneurysm (AA, 19), and aortic rupture (AR, 10) were included in this retrospective study. The clinical endpoints were persistent inflammation at hospital discharge and in-hospital mortality.

Results: AR patients were slightly younger (66.6 ± 11.4) than AD (70.21 ± 8) and AA patient (61.8 ± 15.1 years), whereas AA patients had slightly damaged kidney function (33.33 vs. 26% and 10%, p = 0.43) and suffered more form arterial hypertension (95.24 vs. 68.4% and 60.0%, p < 0.05) when compared to AA and AR patients, respectively. Whereas WBC remained comparable in all groups before (9.9 ± 3.4, 8.6 ± 2.7 and 9.6 ± 2.7) and after the intervention (9.96 ± 4.6, 9.94 ± 2.7 and 8.6 ± 2.6 in AD, AA, and AR, respectively), CRP values increased in all groups after TEVAR (156.6 ± 94.5, p < 0.001; 108.1 ± 57.7, p < 0.01 and 117.8 ± 70.4, p < 0.05) compared to baseline levels (58.1 ± 77.5, 31.94 ± 52.1, and 31.9 ± 52.1, in AD, AA, and AR, respectively), and this increase was more accentuated in the AD patients (p < 0.05 vs. AA).

Hospital stay was similar in AD (12.6 ± 7.3 days) and AA (12.7 ± 7.2 days) patients and slightly prolonged in AR patients (15.7 ± 11.2 days, P = 0.192 vs. AD). PIS was diagnosed in 3.06% of all patients. Cohort mortality was 8% and did neither correlate with PIS nor with the preoperative parameters.

Conclusions: The presence of aortic dissection was associated with more inflammation after TEVAR than aortic aneurysms or aortic rupture. Inflammation did neither prolong hospital stay nor was a predictor for mortality after TEVAR.