P236. Optimizing Postoperative Surveillance Imaging Following Elective Aortic Hemiarch Replacement
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
University of Colorado Anschutz
Denver, CO
United States - Contact Me
Adam Carroll is a current PGY-3 surgical resident at the University of Colorado. Adam attended medical school at the University of Colorado and has been involved in research with the cardiothoracic surgery department throughout medical school and residency. He has interest specifically in endovascular and transcatheter aortic interventions, as well as neurologic outcomes in aortic research. He is currently in the aortic surgery research labaratory in the Department of Cardiothoracic Surgery at the University of Colorado. He plans to pursue a career in cardiothoracic surgery following his general surgery residency.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective:
The optimal protocol for imaging following aortic hemiarch replacement remains a topic of debate. At our institution, pathology related to the repair typically occurs within the first three months postoperatively. We hypothesize surveillance CT scans performed at 3 months will identify any pathologies requiring re-intervention; additional imaging may be superfluous.
Methods:
Using our single institution-maintained database, 417 patients who underwent an elective aortic hemiarch repair between February of 2010 and December of 2022 were identified. Eight patients (1.9%) who had an in-hospital postoperative mortality were excluded from analysis. For the remaining 409, the stability of post-operative imaging and follow-up with cardiovascular providers was reviewed. Patients requiring re-intervention related to hemiarch replacement were identified, with additional focus on whether pathology was detected during routine post-operative surveillance imaging.
Results:
Of the 409 patients who underwent elective aortic hemiarch repair, 391 (95.4%) completed post-operative follow-up with a cardiovascular provider. A total of 21 patients required operative re-intervention after discharge (5.1%). Of those, 14 patients presented urgently or emergently with symptoms related to their pathology. Only 7 patients (1.7%) had pathology requiring re-intervention found on surveillance imaging. Of those, 4 patients required re-intervention based on their post-hemiarch surveillance imaging, with all pathology detected at three-months. Three patients required re-intervention for surveillance imaging related to other pathology: two patients had distal degeneration of known descending thoracic aortic aneurysms on annual surveillance imaging, and one patient required re-intervention at eight years required to stenosis of their mechanical aortic valve. The Kaplan-Meier survival curve (Figure 1) details duration of follow-up and expected freedom from re-intervention after elective hemiarch replacement.
Conclusions:
This data supports surveillance imaging completed at 3 months following hemiarch replacement is sufficient to identify pathology related to the repair. While other indications may dictate ongoing surveillance, for most patients, the need for further imaging is unnecessary.
Authors
Adam Carroll (1), Nicolas Chanes (1), Zihan Feng (1), Cenea Kemp (1), Austin Gronewold (1), Muhammad Aftab (1), T. Brett Reece (1)
Institutions
(1) University of Colorado Anschutz, Denver, CO
The optimal protocol for imaging following aortic hemiarch replacement remains a topic of debate. At our institution, pathology related to the repair typically occurs within the first three months postoperatively. We hypothesize surveillance CT scans performed at 3 months will identify any pathologies requiring re-intervention; additional imaging may be superfluous.
Methods:
Using our single institution-maintained database, 417 patients who underwent an elective aortic hemiarch repair between February of 2010 and December of 2022 were identified. Eight patients (1.9%) who had an in-hospital postoperative mortality were excluded from analysis. For the remaining 409, the stability of post-operative imaging and follow-up with cardiovascular providers was reviewed. Patients requiring re-intervention related to hemiarch replacement were identified, with additional focus on whether pathology was detected during routine post-operative surveillance imaging.
Results:
Of the 409 patients who underwent elective aortic hemiarch repair, 391 (95.4%) completed post-operative follow-up with a cardiovascular provider. A total of 21 patients required operative re-intervention after discharge (5.1%). Of those, 14 patients presented urgently or emergently with symptoms related to their pathology. Only 7 patients (1.7%) had pathology requiring re-intervention found on surveillance imaging. Of those, 4 patients required re-intervention based on their post-hemiarch surveillance imaging, with all pathology detected at three-months. Three patients required re-intervention for surveillance imaging related to other pathology: two patients had distal degeneration of known descending thoracic aortic aneurysms on annual surveillance imaging, and one patient required re-intervention at eight years required to stenosis of their mechanical aortic valve. The Kaplan-Meier survival curve (Figure 1) details duration of follow-up and expected freedom from re-intervention after elective hemiarch replacement.
Conclusions:
This data supports surveillance imaging completed at 3 months following hemiarch replacement is sufficient to identify pathology related to the repair. While other indications may dictate ongoing surveillance, for most patients, the need for further imaging is unnecessary.
Authors
Adam Carroll (1), Nicolas Chanes (1), Zihan Feng (1), Cenea Kemp (1), Austin Gronewold (1), Muhammad Aftab (1), T. Brett Reece (1)
Institutions
(1) University of Colorado Anschutz, Denver, CO
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.
View Submission
- P0236 - Optimizing Postoperative Surveillance Imaging Following Elective Aortic Hemiarch Replacement