LAUSR

Objective: Thoracic Endovascular Aortic Repair (TEVAR) currently represents the gold standard of treatment for blunt thoracic aortic injury (BTAI). Nevertheless there is an ongoing debate surrounding its safety and efficacy and its subsequent cardiovascular effects. The present study is aimed at assessing heart and aortic structure and function after TEVAR in BTAI young patients. Design and method: In 20 patients (18 men, age 41 ± 14 years) treated with TEVAR (11 with Gore CTAG, 9 with Medtronic Valiant) after BTAI, between 2004–2015, after a median follow-up time of 3 years (range 12-1 years; T1) we measured brachial Blood Pressure (BP, sfigmomanometry) and Pulse Wave velocity (cfPWV, sphygmocor) and obtained an echocardiogram with Left Ventricular Mass Index (LVMI) calculation. Results: At baseline all the patients were normotensive; At T1 evaluation patients showed mean normal BP value (131 ± 12/85 ± 10) while 11 of them (55%) were hypertensives. Also LVMI (81,84 ± 28,11 g/m2) and PWV (7,58 ± 1,48 m/s) mean values were within the normal range. When patients were divided accordingly to the used graft patients treated with Medtronic Valiant showed a significantly higher LVMI (97.17 ± 35.78 vs 69.58 ± 11.24 g/m2; p < 0,05) and PWV (7,78 ± 1,74 vs 6,45 ± 1,54 m/s; p < 0,05) compared with those treated with Gore CTAG. Same figures were fouded when patients were divided accordingly to the treating time with those treated more than 3 years before the evaluation that showed higher LVMI (91,16 ± 34,73 vs 70,20 ± 9,44 g/m2; p < 0,01) and PWV (7,50 ± 1,98 vs 6,38 ± 1,04 m/s; p < 0,05). Conclusions: Our study showed for the first time that descending aorta TEVAR for BTAI is associated after some years with the development of hypertension and heart and vascular alterations. The presence of TEVAR modify aortic functional properties and induce in young subject an increase in BP and LVMI probably related to the presence of a rigid aorta .These findings suggest to include a cardiologic follow up of young patients treated with TEVAR.