D. Acheampong1, P. Paul1, P. Boateng1, I. Leitman1 1Mount Sinai School Of Medicine,New York, NY, USA
Introduction: Cardiac events (CE) following TEVAR have been associated with morbidity and mortality. A large risk-adjusted database was used to understand contributing factors.
Methods: A retrospective analysis was performed for completed procedures done from 2010-2015 using the American College of Surgeons -National Surgical Quality Improvement Program (ACS-NSQIP) participant user file. Adult patients (≥18 years) who underwent TEVAR were identified and 30-day outcomes were examined. Initial univariate analysis was conducted on all pre-operative risk factors. Univariate and multivariate analyses were performed to assess risk factors for CE following TEVAR. A P-value of < 0.05 was considered statistically significant.
Results: The study identified 130 out of 2403 (5.4%) patients who underwent TEVAR that developed cardiac events as defined by ACS-NSQIP. Pre-operative leukocytosis, ASA score ³3 and functional dependence were associated with CE post-TEVAR. Underlying major risk factors for CE included emergency operation (53.43% vs 18.58%, p<0.01), ventilator dependence (15.38% vs 0.17%, p<0.01), currently on dialysis (11.53% vs 3.77%, p<0.01), SIRS (19.23% vs 6.30%, p<0.01), sepsis (3.84% vs 0.87%, p<0.01) and septic shock (2.3% vs 0.01%, p<0.01). Patients with postoperative renal failure (3.84% vs 0.99%, p<0.01), unplanned return to operating room (21.53% vs 9.37%, p<0.01) and operation time >180mins (37.7% vs 26.8%, p<0.01) also had increased associated post-operative cardiac events. CE greatly increased mortality (60.8% vs 2.2%).
Conclusion: CE following TEVAR is associated with significant mortality. Patients with identified risk factors should carefully observed following intervention.
