Clinical Research Of Thoracic Endovascular Aortic Repair By Echocardiography

Objective:Evaluate the feasibility and outcome of thoracic endovascular aortic repair for descending aortic dilatation disease By echocardiography.Methods:From March2011to December2011, there were31patients of descending thoracic aortic disease who need thoracic endovascular aortic repair (TEVAR). After filtration by transthoracic echocardiography and CTA before operation,12patients were chosen for TEVAR by echocardiography as echocardiography group. The criteria of echocardiography group is that the images of aortic arch and its main branches are clear under long axis view of aortic arch. The rest19patients received TEVAR by digital subtraction angiography (DSA) as DSA group. Evaluate the feasibility and outcome of TEVAR by echocardiography by comparison of the two groups from aspects of perioperative outcomes, postoperative complications, operation security, operation cost, follow-up data and so on.Results:In echocardiography group,10patients successfully received TEVAR treatment by echocardiography,10aortic stents were used in all; left subclavian artery (LSA) was covered in one patient; one patient received TEVAR treatment by DSA, and one patient received open-chest operation. In DSA group,19patients succeeded,19aortic stents were used in all; left subclavian artery was covered in2patients. All the stents were located well; all the aortic tears and aortic ulcers were covered.There were no statistical differences on preoperative clinical information between the two groups except body mass index (p=0.001). The aortic stents were located accurately in both groups, and all the false lumens, intimal ulcers and aneurysms were excluded. Statistical analysis of operative and postoperative data showed that there were obvious differences on operation time, operation costs between the two groups (p<0.001). Follow-up data showed no differences between the two groups on operation outcomes, complication incidence,survival rate,maximum diameter of the thoracic aorta,maximum diameter of the abdominal aorta,thoracic aortic thrombus completely and remodeling rate.Conclusion:Thoracic endovascular aortic repair by echocardiography is useful and safe for certain patient of descending thoracic aortic disease. TEVAR by echocardiography is cheaper and provide a new strategy and method for descending thoracic aortic disease.