Ascending Geometry Changes after Thoracic Endovascular Aortic Repair for Descending Aortic Dissection

Background: Aim of this study was to identify geometry changes of the ascending aorta up to 3-years after TEVAR for descending aortic dissection. Furthermore, potential general risk factors as well as morphological risk factors for diameter and length change after one year were analyzed.

Methods: This work is a single center, multidisciplinary imaging study. 102 patients who underwent TEVAR in Universitätsklinik-Herzzentrum Freiburg between 04/2009 and 07/2021 were analyzed in a retrospective fashion. Computed tomography angiographic scans were transferred to a dedicated imaging software and detailed aortic measurements (including length, diameter and area) were taken in multiplanar reconstruction postoperatively, after six months and annually thereafter. Changes in measurements were analyzed using repeated measures ANOVA and risk factors with regression.

Results: There was no significant change in ascending aortic diameter or cross-area at the annulus, ascending aorta or at the level of the brachiocephalic trunk (P > 0.05) 3-years after TEVAR procedure. Similarly, ascending aortic volume did not show significant changes after TEVAR either (p = 0.383). As for ascending aorta length, there was a significant difference between 6-months post-op and 3 years post-op (p = 0.019). Ascending aortic length immediately post-op was not significantly different from any other time point (p = 0.013). As for risk-factors, history of coronary artery disease was associated with decreased ascending aortic length and diameter 1-year after TEVAR (p = 0.034; p = 0.030), and height was associated with decreased diameter only (p = 0.013).

Conclusion: TEVAR does not seem to lead to ascending aortic enlargement after 3-years of follow-up. Patients with a history of coronary artery disease or increased body height are even less likely to be affected by increases in ascending aortic geometry.

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Artikel online veröffentlicht:
13. Februar 2024