Endovascular Aortic Aneurysm and Dissection Repair (EVAR) in Iran: Descriptive Midterm Follow-up Results.
BACKGROUND
Endovascular repair of aorta in comparison to open surgery has a low early operative mortality rate, but its long-term results are uncertain.


OBJECTIVE
The current study describes for the first time our initial four-year experience of elective endovascular aortic repair (EVAR) at Tehran heart center, the first and a major referral heart center in Iran, as a pioneer of EVAR in Iran.


METHODS
A total of 51 patients (46 men) who had the diagnosis of either an abdominal aortic aneurysm (AAA) (n = 36), thoracic aortic aneurysm (TAA) (n = 7), or thoracic aortic dissection (TAD) (n = 8) who had undergone EVAR by Medtronic stent grafts by our team between December 2006 and June 2009 were reviewed.


RESULTS
The rate of in-hospital aneurysm-related deaths in the group with AAA stood at 2.8% (one case), while there was no in-hospital mortality in the other groups. All patients were followed up for 13-18 months. The cumulative death rate in follow-up was nine cases from the total 51 cases (18%), out of which six cases were in the AAA group (four patients due to non-cardiac causes and two patients due to aneurysm-related causes), one case in the TAA group (following a severe hemoptysis), and two cases in the TAD group (following an expansion of dissection from re-entrance). The major event-free survival rate was 80.7% for endovascular repair of AAA, 85.7% for endovascular repair of TAA, and 65.6% for endovascular repair of TAD.


CONCLUSIONS
The endovascular stent-graft repair of the abdominal and thoracic aortic aneurysm and aortic dissection had high technical success rates in tandem with low-rate early mortality and morbidity, short hospital stay, and acceptable mid-term free symptom survival among Iranian patients.
Department of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Ali Mohammad
AM
Haji Zeinali
Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Mehrab
M
Marzban
Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohammadreza
M
Zafarghandi
Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Mahmood
M
Shirzad
Department of Radiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Shapour
S
Shirani
Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Roshanak
R
Mahmoodian
Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Mehrdad
M
Sheikhvatan
Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Masoumeh
M
Lotfi-Tokaldany
Aortic Aneurysm; Aortic Diseases; Dissecting; Endovascular Procedure; Iran