Comparing TEVAR and Open Surgery for Type B Aortic Dissection
Author Information
Author(s): Michael E. Brunt, Natalia N. Egorova, Alan J. Moskowitz
Primary Institution: Mount Sinai School of Medicine
Hypothesis
Does thoracic endovascular aortic repair (TEVAR) provide better outcomes than open surgical repair for type B aortic dissections?
Conclusion
TEVAR results in better in-hospital outcomes for emergently admitted patients with type B aortic dissection compared to open repair.
Supporting Evidence
- In-hospital mortality was significantly higher following open repair than TEVAR in emergently admitted TBAD patients (17.5% vs 10.8%).
- There was no significant difference in in-hospital mortality between open repair and TEVAR for elective admissions (5.6% vs 3.3%).
- Hospitals performing thirty or more TEVAR procedures annually had lower mortality for emergent TBAD than hospitals with fewer than thirty procedures.
Takeaway
Doctors found that a less invasive surgery called TEVAR is safer than traditional surgery for patients with a serious type of aortic problem when they come to the hospital in an emergency.
Methodology
The study analyzed data from the Nationwide Inpatient Sample database from 2005 to 2008, comparing outcomes of TEVAR and open surgical repair using propensity score matching.
Potential Biases
Potential selection bias due to differences in patient demographics and comorbidities between treatment groups.
Limitations
The study is observational and may have biases due to differences in patient characteristics and coding errors in comorbidity data.
Participant Demographics
Patients included both emergently and electively admitted individuals with type B aortic dissections, with varying comorbidities.
Statistical Information
P-Value
0.045
Statistical Significance
p=0.045
Digital Object Identifier (DOI)
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