Outcomes of thoracic endovascular aortic repair. 10-years follow-up in LATAM population: experience from a tertiary care center in Mexico

Jhonathan Uribe-Gonzalez, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI; Department of Interventional Cardiology, ABC Medical Center; Mexico City, Mexico
Erick Trujillo-Virgen, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Daniela L. Leocachin-Parra, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Silvestre Montoya-Guerrero, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Horacio Márquez-González, Department of Congenital Heart Diseases, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Agustín Campuzano-Madrid, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Efraín Arizmendi-Uribe, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Eileen Amaro-Balderas, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
Daniel Campuzano-González, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
Joel Estrada-Gallegos, Department of Interventional Cardiology, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City, Mexico

Background: Thoracic aortic pathologies comprise a broad group of conditions affecting one or more layers of the aorta, some of which are known to be life-threatening. The development of thoracic aortic endovascular repair (TEVAR) has enabled a minimally invasive approach for treating these cases, with excellent long-term results. Objective: To describe clinical and technical outcomes of patients who underwent thoracic endovascular aortic repair (TEVAR) in a single tertiary care center. Method: An observational, descriptive, retrospective cohort study. We included patients of 18 years-old or older who underwent TEVAR either as a single procedure or as part of a hybrid repair, between 2011 and 2023, in the Cardiology Hospital of the National Medical Centre XXI Century. Results: A total of 66 patients were included, of whom 77.2% were men. The most frequent cardiovascular risk factors were hypertension and tobacco use. TEVAR was performed as a single procedure in 57.6% (n = 38) and as a hybrid repair in 42.4% (n = 28). Technical success was achieved in 95.4% (n = 63). Event-free survival was 81.8% (n = 54) during hospitalization, 81.5% (n = 54) at 30 days, 76.9% (n = 50) at 1 year, 75.4% (n = 43) at 5 years, and 63.6% (n = 21) at 10 years. Adverse events occurred in 27.2% (n = 18) of cases, most commonly vascular access complications (12.1%, n = 8), spinal cord ischemia (4.5%, n = 3), and reintervention (4.5%, n = 3). Conclusion: In this retrospective single-center experience, TEVAR demonstrated high technical success and acceptable mid- and long-term event-free survival. These findings support the feasibility and effectiveness of TEVAR in a tertiary-level care setting.

Keywords: Thoracic endovascular aortic repair. Aortic dissection. Aortic aneurysm. Aortic arch. Aortic diseases. Endovascular aneurysm repair.