PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg 2025; 73(06): 456-467
DOI: 10.1055/s-0044-1791947
Original Cardiovascular

Unpredictable Aortic Behavior in Identifying Risk Factors for Reintervention: A Prospective Cohort Study

Autoren

  • Mohamed Eraqi

    1   Department of Cardiac Surgery, Klinikum Bayreuth GmbH, Bayreuth, Germany
    2   Department of Cardiac Surgery, Heart Center Dresden, Carl Gustav Carus University Hospital, Dresden, Germany
    3   Division of Health Care Sciences, Dresden International University, Dresden, Germany

  • Tamer Ghazy

    2   Department of Cardiac Surgery, Heart Center Dresden, Carl Gustav Carus University Hospital, Dresden, Germany
    4   Department of Cardiac Surgery, Phillips University, Marburg, Germany

  • Tiago Cerqueira

    3   Division of Health Care Sciences, Dresden International University, Dresden, Germany

  • Jennifer Lynne Leip

    5   Northeastern University, Boston, Massachusetts, United States

  • Timo Siepmann

    3   Division of Health Care Sciences, Dresden International University, Dresden, Germany
    6   Department of Neurology, Medical Faculty, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany

  • Adrian Mahlmann

    7   Department of Internal Medicine III, Medical Faculty, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
    8   Center for Vascular Medicine, Clinic of Angiology, St.-Josefs-Hospital, Katholische Krankenhaus Hagen gem. GmbH, Hagen, Germany
Weitere Informationen
  Lizenzen und Reprints Alle Artikel dieser Rubrik

Abstract

Background

Although advancements in the management of thoracic aortic disease have led to a reduction in acute mortality, individuals requiring postoperative reintervention experience substantially worse long-term clinical outcomes and increased mortality. We aimed to identify the risk factors for postoperative reintervention in this high-risk population.

Patients and Methods

This prospective observational cohort study included patients who survived endovascular or open surgical treatment for thoracic aortic disease between January 2009 and June 2020. We excluded those with inflammatory or traumatic thoracic aortic diseases. The risk factors were identified using multivariate logistic regression and Cox proportional hazards regression models.

Results

The study included 95 genetically tested patients aged 54.13 ± 12.13 years, comprising 67 men (70.53%) and 28 women (29.47%). Primary open surgery was performed in 74.7% and endovascular repair in 25.3% of the patients. Of these, 35.8% required one or more reinterventions at the time of follow-up (3 ± 2.5 years, mean ± standard deviation). The reintervention rate was higher in the endovascular repair group than in the open repair group. Among the potential risk factors, only residual aortic dissection emerged as an independent predictor of reintervention (odds ratio: 3.29, 95% confidence interval: 1.25–8.64).

Conclusion

Reintervention after primary thoracic aortic repair remains a significant clinical issue, even in high-volume tertiary centers. Close follow-up and personalized care at aortic centers are imperative. In our cohort of patients with thoracic aortic disease undergoing open or endovascular surgery, postoperative residual dissection was independently associated with the necessity of reintervention, emphasizing the importance of intensified clinical monitoring in these patients.

Keywords

thoracic aorta - endovascular repair - reintervention - aortic dissection

Authors' Contribution

M.E. and T.G. contributed to the conceptualization; M.E., T.C., and T.S. to methodology ; M.E. and J. L. L. to software; A.M, T.C., and T.S. to validation; M.E. and J.L.L. to formal analysis; T.G., A.M., and T.S. to investigation; T.G., J.L.L., and A.M. to resources; T.G., J.L.L., and A.M. to data curation; M.E. to writing—original draft preparation; T.C., T.S., J.L.L., and A.M. to writing—review and editing; A.M., T.C., and T. S. to supervision; and none to funding acquisition.




Publikationsverlauf

Eingereicht: 16. April 2024

Angenommen: 24. September 2024

Artikel online veröffentlicht:
18. November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany