Insights in Pediatric Cardiology

Endovascular versus Open Surgical Repair for Isolated Ruptured Descending Thoracic Aorta: A Systematic Review and Meta-Analysis

The purpose of this study was to compare clinical outcomes between open and thoracic endovascular aortic repair (TEVAR) in isolated ruptured descending thoracic aorta. Methods: A comprehensive electronic search was undertaken to identify all published data comparing open versus endovascular repair in ruptured descending thoracic aorta. Databases where evaluated to March 2018. Results: A total of 29,133 patients were analysed in 19 articles. Mean age was similar in both group of patients (54.6±12.8 yrs vs 54.6±13.5 yrs, p=0.19). Shorter ICU and total hospital stay in TEVAR (6.9±5.9 vs 9.1±6.6 days, p=0.003 and 16.5±8.9 vs 19.8±10 days, p=0.009 respectively). Paraplegia and stroke were higher in TEVAR with no statistical significance (2.5% vs 1.6%, p=0.47, and 1.7% vs 0.84%, p=0.62 respectively). There was also higher rate of re-intervention at one year in the TEVAR (p=0.001). While, a lower in-hospital mortality noted in TEVAR (6.5% vs 10.2% respectively, p=0.003), but no statistical difference in mortality rates at one and five years (p=0.51 and p=0.33 respectively).

Amer Harky, Francesca Gatta David Bleetman, Peter Erekson, Grace Chaplin, Beverly McCarthy, Shirish Ambekar, Neil Roberts, Aung Oo