Effect of endoprostheses on pulse wave velocity and its long-term outcomes after thoracic endovascular aortic repair.

Abstract

BACKGROUND:

The purpose of this study was to evaluate the changes in pulse wave velocity and left ventricular dimensions in patients undergoing stent-graft treatment for aortic arch aneurysm.

METHODS:

From July 2008 to February 2019, 86 patients underwent thoracic endovascular aortic repair of an aortic arch aneurysm. Changes in pulse wave velocity (PWV), echocardiogram findings, and long-term outcomes were compared between endoskeleton type (n = 60) and exoskeleton type stent-graft (n = 26).

RESULTS:

There was no significant difference in patient demographics except for diabetes which was more observed in endoskeleton type (p = 0.017). There was a significant increase in PWV in exoskeleton type after surgery, which further progressed at a median follow-up of 32 months (before: 2047 cm/s vs. after: 2259 cm/s vs. follow-up: 2486 cm/s, p = 0.010, p = 0.017). No significant difference was observed in endoskeleton type (before: 1980 cm/s vs. after: 2058 cm/s, vs. follow-up: 2042 cm/s, p = 0.25, p = 0.34). Echocardiogram performed at a median period of 46.3 months, revealed a significant increase in left ventricular diastolic volume (LVDV) (before: 107.4 ± 20.6 ml vs. follow-up: 127.7 ± 27.5 ml, p = 0.003) and decrease in e' (before: 5.5 ± 1.78 cm/s vs. follow-up: 4.7 ± 1.72 cm/s, p = 0.012) in exoskeleton type, while no significant change was observed in endoskeleton type (LVDV: before: 102.6 ± 32.3 ml vs. follow-up: 96.9 ± 35.4 ml, p = 0.74; e': before: 4.4 ± 1.21 cm/s vs. follow-up: 4.8 ± 1.40 cm/s, p = 0.68). At the median period of 61.3 months, there was no significant difference in long-term mortality (p = 0.89). However, the endoskeleton type was associated with a lower incidence of a cardiac event (p = 0.034) and cerebrovascular event (p = 0.029).

CONCLUSION:

Types of endoprosthesis might affect differently on physiological changes and its accommodated risk factors after surgery.

• Authors: Daijiro Hori, Koichi Yuri, Sho Kusadokoro, Toshikazu Shimizu, Naoyuki Kimura, Atsushi Yamaguchi
• Journal: General thoracic and cardiovascular surgery (Gen Thorac Cardiovasc Surg) Vol. 68 Issue 10 Pg. 1134-1141 (Oct 2020) ISSN: 1863-6713 [Electronic] Japan
• PMID: 32232780 (Publication Type: Journal Article)

Topics

• Aged
• Aorta, Thoracic (physiopathology, surgery)
• Blood Vessel Prosthesis
• Blood Vessel Prosthesis Implantation (adverse effects)
• Cardiovascular Diseases (epidemiology)
• Endovascular Procedures (methods)
• Female
• Heart Ventricles (anatomy & histology)
• Humans
• Incidence
• Male
• Middle Aged
• Postoperative Complications (epidemiology)
• Prosthesis Design
• Pulse Wave Analysis
• Risk Factors
• Stents
• Treatment Outcome
• Ventricular Function, Left