Alexander I. Kraev , MD Andrew Nguyen, MD R Anthony Perez-Tamayo, MD PhD Gregg Landis, MD

Short Term Outcomes in Endovascular and Open Repair of Thoracic Aortic Aneurysms Are Controversial Through NSQIP Alexander I. Kraev, MD Andrew Nguyen, MD R Anthony Perez-Tamayo, MD PhD Gregg Landis, MD Aortic Symposium 2012

National Surgical Quality Improvement Program (NSQIP) • Administered by the American College of Surgeons • Join Commission Surgical Care Improvement Project • 400 Centers participating across United States • Teaching and non-teaching hospitals • 136 Perioperative variables measured • Preoperative risk factors • Intraoperative variables • 30-day post-op morbidity and mortality outcomes Aortic Symposium 2012

TEVAR • Thoracic Endovascular Aneurysm Repair • Minimally invasive option to the traditional open repair • Initial experience at specialty institutions • Highly favorable towards TEVAR • Currently widely adopted across the country • Prospective and long-term studies are lacking Aortic Symposium 2012

NSQIP 2005-2009 Database • 12162 total aortic cases • 7374 endovascular repairs • 4788 open repairs Aortic Symposium 2012

NSQIP Database Aortic Symposium 2012

Descriptive Statistics Aortic Symposium 2012

TEVAR vs Open Mortality Aortic Symposium 2012

TEVAR vs Open: Cardiac Outcomes • Combined end-point of cardiac arrest or acute myocardial infarction Aortic Symposium 2012

TEVAR vs Open: Pulmonary Outcomes • Combined end-point of prolonged intubation, re-intubation, pulmonary embolism, or pneumonia Aortic Symposium 2012

TEVAR vs Open: Renal Outcomes • Combined end-point of acute renal insufficiency or acute renal failure Aortic Symposium 2012

TEVAR vs Open: Post-Operative Stroke Aortic Symposium 2012

Conclusion • Short term mortality of TEVAR and open repair are equivalent • Operative time, anesthesia time, and length of stay are shorter in TEVAR • Pulmonary and renal outcomes are superior in TEVAR • Stroke rate is higher in TEVAR Aortic Symposium 2012

Alexander I. Kraev , MD Andrew Nguyen, MD R Anthony Perez-Tamayo, MD PhD Gregg Landis, MD

Alexander I. Kraev , MD Andrew Nguyen, MD R Anthony Perez-Tamayo, MD PhD Gregg Landis, MD

Presentation Transcript

Tianhong Pan, MD, PhD; Wenjie Xie, MD; Pawan Rawal,MD Joseph Jankovic, MD; Weidong Le, MD, PhD

François Schiele , MD, PhD, Nicolas Meneveau , MD, PhD,

A Kheirkhah MD, A Izadi MD, R Nazari MD H Hashemi MD, M Jabbarvand MD, H Hashemian MD

Michael R. Folkert, MD PhD, Samuel Singer, MD, Murray F. Brennan, MD,

Gregg W. Stone, MD

Renato Ambrósio Jr., MD, PhD Ruiz Alonso, MD; Allan Luz, MD; Daniela Jardim, MD;

Laurence de Leval, MD, PhD,* David Waltregny, MD, PhD,w Jacques Boniver, MD, PhD,*

Robert R. Althoff, MD, PhD; James J. Hudziak, MD; Frank C. Verhulst, MD, PhD;

R Mehanna MD 1 ; AG Machado MD, PhD 2 ; S Oravivattanakul MD 2 ; G Genc MD 2 ; SE Cooper MD, PhD 2

Bokkwan Jun MD, John P Berdahl MD, Anthony N Kuo MD, Thomas J Cummings MD, Terry Kim MD

Gregg W. Stone, MD

Tianhong Pan, MD, PhD; Wenjie Xie, MD; Pawan Rawal,MD Joseph Jankovic, MD; Weidong Le, MD, PhD

Gregg W. Stone, MD Manejeh Yaqub, MD; Poornima Sood, MD, MBA; Ali Rizvi, MD;

Szabolcs Péter , MD, PhD Peter Weber, MD, PhD

Gregg W. Stone, MD

Gregg W. Stone, MD

Don Davis, MD, Peter Ness, MD, Surekha Maddula, MD, Liliana Werner, MD, PhD, Nick Mamalis, MD

Gregg W. Stone MD