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Though the application of thoracic endovascular aortic repair (TEVAR) for treatment of aortic pathology is expanding, there remains a gap in the literature examining how intraoperative "reduction or elimination of aortic impulse" (REAI) techniques, in particular the use of right atrial occlusion, may impact patient important clinical outcomes. This study aims to provide prospective data from a large cohort of TEVAR patients to explore clinical outcomes following TEVAR procedures and, specifically, whether right atrial occlusion has significant impact on clinical outcomes, as compared to other REAI techniques. The results from this study may inform future perioperative TEVAR practices and improve TEVAR patient outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Right atrial balloon occlusion | Thoracic endovascular aortic repair with right atrial balloon occlusion for reduction or elimination of aortic impulse |
| |
| Non right atrial balloon occlusion | Thoracic endovascular aortic repair not using right atrial balloon occlusion for reduction or elimination of aortic impulse |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Right atrial balloon occlusion | Procedure | Thoracic endovascular aortic repair with right atrial balloon occlusion for reduction or elimination of aortic impulse and stent graft deployment in landing zones 0-3 |
| Measure | Description | Time Frame |
|---|---|---|
| Endoleak occurrence up to hospital discharge | Endoleak occurrence prior to hospital discharge | end of surgery to hospital discharge up to 10 days) |
| Endoleak occurrence to one-year post-surgery | Endoleak occurrence within one-year of surgery | end of surgery to one-year post-surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Perioperative mortality to 30 days post-surgery | 30-day perioperative mortality | post-surgery to 30 days post-surgery |
| All-cause mortality to one-year post-surgery | One-year all-cause mortality |
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Inclusion Criteria:
Exclusion Criteria:
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All patients undergoing emergency or elective thoracic endovascular aortic repair at the Peter Lougheed Centre, Calgary, Alberta
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Claire Allen, MD, FRCPC | Contact | 403- | claire.allen@ahs.ca |
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| ID | Term |
|---|---|
| D017545 | Aortic Aneurysm, Thoracic |
| D000094629 | Dissection, Thoracic Aorta |
| ID | Term |
|---|---|
| D001014 | Aortic Aneurysm |
| D000783 | Aneurysm |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| Non right atrial balloon occlusion | Procedure | Thoracic endovascular aortic repair not using right atrial balloon occlusion for reduction or elimination of aortic impulse and stent graft deployment in landing zones 0-3 |
|
| post-surgery to one-year post-surgery |
| Complications: massive hemorrhage | Occurrence of massive hemorrhage | within 30 days post-surgery and at 1 year |
| Complications: cerebrovascular | Occurrence of cerebrovascular accident/transient ischemic attack | within 30 days post-surgery and at 1 year |
| Complications: spinal cord ischemia | Occurrence of spinal cord ischemia | within 30 days post-surgery and at 1 year |
| Complications: iliofemoral access | Occurrence of iliofemoral access complications (bleeding/infection/thrombosis) | within 30 days post-surgery and at 1 year |
| Complications: retrograde dissection | Occurrence of retrograde dissection | within 30 days post-surgery and at 1 year |
| Complications: prolonged ventilation | Occurrence of prolonged ventilation for more than 24 hours | within 30 days post-surgery and at 1 year |
| Complications: acute kidney injury | Occurrence of acute kidney injury | within 30 days post-surgery and at 1 year |
| Complications: acute kidney injury with renal replacement therapy | Occurrence of acute kidney injury requiring renal replacement therapy | within 30 days post-surgery and at 1 year |
| Complications: cardiovascular events | Occurrence of cardiovascular events (myocardial injury after non-cardiac surgery/cardiac arrest/myocardial infarction) | within 30 days post-surgery and at 1 year |
| D001018 |
| Aortic Diseases |
| D000784 | Aortic Dissection |
| D000094665 | Dissection, Blood Vessel |
| D000094683 | Acute Aortic Syndrome |