P115. Aortic Morphology Changes During Computed Tomography Based Follow Up After Thoracic Endovascular Aortic Repair for Type B Aortic Intramural Hematoma
Fuwai Central China Hospital
Beijing, Beijing
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EDUCATION:
1995 – 2000
Tongji University, China (Shanghai)
Bachelor Degree (Clinical Medical Sciences)
2004 – 2007
Peking Union Medical College & Chinese Academy of Medical Sciences, China (Beijing)
Master Degree (Cardiovascular Surgery)
Master Thesis: Perfusion of Interleukin-1 Receptor Antagonist Attenuates Spinal Cord Injury After Aortic Cross Clamping
PROFESSIONAL EXPERIENCE:
2000 - 2004
First affiliated hospital of Zhengzhou University, China (Zhengzhou)
Residency (Surgery)
Board-certified surgeon in cardiovascular surgery (2001)
2007 - 2009
Peking Union Medical College & Chinese Academy of Medical Sciences, Fuwai hospital, China (Beijing)
Residency (Cardiovascular surgery)
2009 - 2021
Peking Union Medical College & Chinese Academy of Medical Sciences, Fuwai hospital, China (Beijing)
Attending surgeon (Cardiovascular surgery)
2021 -
Peking Union Medical College & Chinese Academy of Medical Sciences, Fuwai hospital, China (Beijing)
Associate Professor (Cardiovascular surgery)
Description
Methods: Participants were consecutively recruited from an institutional registry for acute aortic syndrome between September 2014 and August 2021. We enrolled patients who underwent TEVAR for type B IMH and evaluated the aortic morphological changes based on follow-up computed tomography angiography and clinical outcomes.
Results: The cohort consists of 292 patients (76.0 % male and 24.0% female) with a median age of 62 (interquartile range: 52-68) years old. During the imaging follow-up of 289 (99%) patients, the majority achieved morphological stability or regression (85.5% of female patients and 82.3% of male patients). Both the maximum descending aortic diameter (decreasing from 35.4 mm to 33.4 mm, P < 0.001) and maximum hematoma thickness (decreasing from 10.2 mm to 3.4 mm, P < 0.001) showed significant reductions. Female patients exhibited a higher incidence of newly developed ascending aortic dissection (5.8%, 4/69) compared to male patients (1.4%, 3/220) (P = 0.04). During clinical follow-up (median: 4.0 years, interquartile range: 2.4-5.8 years), the Kaplan Meier estimated 5-year mortality rates were 17.9% for females and 7.5% for males (P=0.02). In multivariable COX regression analysis, female patients were associated with a higher risk of follow-up death (hazard ratio: 2.43, 95% confidence interval: 1.10-5.35, P = 0.03).
Conclusions: Patients with type B IMH demonstrated significant morphological regression in aortic diameter and hematoma thickness following TEVAR. Additionally, female patients were associated with increased risks of newly developed ascending aortic dissection and higher follow-up mortality compared to their male counterparts.
Authors
Chuan Tian (1)
Institutions
(1) Fuwai Hospital, Beijing, Beijing