Thoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases: a position statement from the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Grabenwöger, Martin; Alfonso, Fernándo; Bachet, Jean; Bonser, Robert S.; Czerny, Martin; Eggebrecht, Holger; Evangelista, Arturo; Fattori, Rossella; Jakob, Heinz; Lönn, Lars; Nienaber, Christoph; Rocchi, Guido; Rousseau, Hervé; Thompson, Matt; Weigang, Ernst; Erbel, Raimund

doi:10.1093/eurheartj/ehs074

Cited by 281 publications

(150 citation statements)

References 74 publications

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“…TEVAR is strongly recommended by European and American cardiology and cardiovascular surgery guidelines, particularly in thoracic aortic aneurysms which are 5.5 cm and more and regardless of diameter in thoracic aortic saccular aneurysms. 11,12) Our patient also presented with severe aortic stenosis accompanied by thoracic aortic saccular aneurysms. As far as we are concerned, there is no single case in the literature or data concerning the method of both treatments.…”

Section: Discussionmentioning

confidence: 78%

“…Both in the studies conducted and in European and American cardiology and cardiovascular surgery, thoracic, and aortic disease guidelines, endovascular repair is strongly recommended when descendent saccular aortic aneurysm is appropriate. [9][10][11][12] That is to say, saccular aneurysms require immediate treatment. Aortic aneurysms make TAVI difficult because of the rupture risk both during and after the process and access path.…”

Section: Discussionmentioning

confidence: 99%

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Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

et al. 2014

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SummaryThe prevalence of aortic stenosis (AS) increases in the elderly. They present high surgical risk due to comorbid factors that increase with age. Transcatheter aortic valve implantation (TAVI) is an effective method in patients who present with severe aortic stenosis with a higher surgical risk or who cannot undergo surgical aortic valve replacement (s-AVR). In our case, the presence of saccular thoracic aortic aneurysm with severe AS, which is a vital co-morbidity, requires the treatment of both. The rise in systolic pressure following the TAVI procedure increases the saccular thoracic aneurysm rupture risk and this is why the timing and method of the two treatments become crucial. In this case, which is as far as we know the first and only report in the literature, both TAVI and endovascular thoracic aortic saccular aneurysm repair were applied simultaneously and successfully to the patient via the same transfemoral route. After 1 month, the patient had good functional capacity and there were no complications in control tomography and echocardiography. In this way, we attempted to emphasize with a multidisciplinary study that the patients be assessed carefully before the procedure, and found that even in patients with common peripheral vascular diseases, a transfemoral route could be used together with the proper methods, and that both procedures could be performed simultaneously. (Int Heart J 2014; 55: 459-462) Key words: Transcatheter aortic valve implantation, TEVAR, Aortic aneurysm T he prevalence of aortic stenosis (AS) has increased with the increase in life expectancy. As a result, severe comorbid factors can occur in advanced ages. The surgical replacement of a stenotic aortic valve (s-AVR) can be performed with low operative mortality rates in the absence of serious comorbid conditions. The patients undergoing s-AVR tend to have greater life expectancy and progress in their symptoms. However, 30% of the patients cannot undergo s-AVR due to left ventricular dysfunction, advanced age, and comorbid conditions. 1,2) Performed for the first time on a patient in 2002, transcatheter aortic valve implantation (TAVI) has become the leading treatment option for high risk and inoperable patient groups. One of the comorbid factors that increases the risk in patients is aortic aneurysm. The rupture risk will be increased with the increase in systolic pressure due to the aortic stenosis being treated. Hence, the timing and method of both treatments are of great importance in our high-risk case which was complicated by a thoracic aortic saccular aneurysm and serious aortic stenosis. In this study, thanks to our unique case in the literature, we managed to show that transfemoral aortic valve implantation and endovascular aneurysm repair could be performed simultaneously and successfully using the same femoral route by evaluating them in a detailed multidisciplinary way. Case ReportAn 83 year-old male patient with a history of coronary artery bypass grafting (CABG) and a permanent pacemaker (VVI-R type) follo...

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

et al. 2014

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“…The diameter of the aorta proximal to the dissected segment was 36 mm. Therefore, we selected a stent graft with 36 mm diameter, according to the position statement from the European [8], with almost no oversizing, because the stronger the radial force, the greater the risk of injury to the aortic wall.…”

Section: Case Reportmentioning

confidence: 99%

“…Ballooning was not performed because of the self-expanding nature of the stent and the time required for the remodeling process of the aorta. Moreover, retrograde dissection and rupture of the dissection membrane has been reported due to ballooning [8].…”

Section: Case Reportmentioning

confidence: 99%

Complication of Endoleak and Retrograde Type A Dissection after Stenting of a Ruptured Type B Dissection

Kong¹,

Dong²,

Shen³

2015

Surgery Curr Res

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“…In patients with uncomplicated type B dissection (absence of malperfusion or end-organ ischemia), medical therapy (to control pain and blood pressure) with serial imaging follow-up using CT or magnetic resonance imaging is recommended. Patients with acute complicated type B aortic dissection are treated using thoracic endovascular aortic repair (TEVAR) [26]. However, if patients have contraindications to TEVAR, such as lower extremity arterial disease, tortuosity of the iliac arteries, or/and an inadequate landing zone for the stent graft, open surgical repair should be considered [27].…”

mentioning

confidence: 99%

Acute Aortic Syndrome: Recent Trends in Imaging Assessment Using Computed Tomography Angiography

Kang

Lee

2017

Cardiovasc Imaging Asia

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Multidetector computed tomography (CT) has become the best modality for evaluating an aorta in the acute setting, due to its ability to rapidly detect aortic pathology with high spatial resolution. Moreover, using three-dimensional multiplanar reconstruction, CT scans can provide informative images and accurate measurements of aortic size and other anatomical landmarks. This review focuses on the CT imaging findings of aortic normal anatomy, aortic aneurysm, and the imaging spectrum of acute aortic syndrome, which includes penetrating atherosclerotic ulcer, intramural hematoma, and aortic dissection.

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Cited by 281 publications

References 74 publications

Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

Complication of Endoleak and Retrograde Type A Dissection after Stenting of a Ruptured Type B Dissection

Acute Aortic Syndrome: Recent Trends in Imaging Assessment Using Computed Tomography Angiography

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