Early malperfusion, ischemia reperfusion injury, and respiratory failure in acute complicated type B aortic dissection after thoracic endovascular repair.
BACKGROUND
The aim of this study was to determine the early mortality and major complications of acute complicated type B aortic dissection (ACBD) after thoracic endovascular aortic repair (TEVAR).


METHODS
Twenty-six consecutive patients with ACBD who underwent TEVAR were included. Clinical indications before TEVAR and in-hospital mortality and major complications after TEVAR were analyzed and compared with similar reports.


RESULTS
TEVAR was technically successful in all cases. In-hospital mortality occurred in four patients (15%), and major complications occurred in an additional four patients (15%). Three of the four (75%) of the deaths were associated with malperfusion and ischemia reperfusion injury (IRI), and 3/4 (75%) of the major complications were caused by respiratory failure (RF).


CONCLUSIONS
In-hospital mortality associated strongly with severe end-organ malperfusion and IRI, while major complications associated with RF, during TEVAR. Our results indicate that malperfusion, IRI and respiratory failure during TEVAR should be carefully monitored and aggressively treated.
Departments of Vascular Surgery, Clinical Division of Surgery, Chinese PLA General Hospital, Beijing, China.
Jiang
J
Xiong
Minhong
M
Zhang
Wei
W
Guo
Xiaoping
X
Liu
Tai
T
Yin
Xin
X
Jia
Hongpeng
H
Zhang
Yongle
Y
Xu
Lijun
L
Wang
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015427:Reperfusion Injury / Q000150:complications; D012131:Respiratory Insufficiency / Q000150:complications; D012189:Retrospective Studies