Abstract No. 592 TEVAR for complicated type B aortic dissection: utilizing 2020 guidelines for outcomes assessment

Abstract

The 2020 Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards were developed for type B dissection. This study seeks to analyze outcomes in patients undergoing TEVAR utilizing the guidelines. Data for patients undergoing TEVAR from 2001 to 2019 in a single-center, retrospective review was analyzed. Patient demographics, comorbidities, and postoperative outcomes were obtained. Computed tomography angiography was utilized to assess preoperative imaging and to identify the proximal entry and distal re-entry. Primary outcomes were postoperative complications and 30-day mortality. Data was analyzed using univariate analysis. There were 64 patients that underwent TEVAR for complicated type B aortic dissection. The mean age was 60 years old. 79.68% of patients had a history of hypertension. 90.6% of patients had general anesthesia and 9.38% had spinal anesthesia. 7.8% of patients had a spinal drain. Intraoperative complications occurred for 3.1% of patients, minor and major perioperative complications occurred for 31.2% of patients, and late onset complications occurred for 14.1% of patients. 4.7% of patients had a neurologic complication. The majority of patients had proximal entry at Zone III (50%), followed by Zone IV (14.1%). Distal re-entry was zone 11 in the majority of patients (37.5%) followed by Zone 9 (12.5%) and Zone 10 (12.5%). Mortality was 12.5% for patients with proximal entry at Zone 3, 11.1% for patients with proximal entry at Zone 4, 25% for patients with distal reentry at Zone 11. Utilizing these reporting standards as a basis for outcomes studies may allow for risk stratification of patients with Complicated type B aortic dissections and future models to predict postoperative outcomes.