Date of Award
January 2024
Document Type
Open Access Thesis
Degree Name
Medical Doctor (MD)
Department
Medicine
First Advisor
Roland R. Assi
Abstract
a. Hypothesis: We hypothesize that Thoracic Endovascular Aortic Repair (TEVAR) leads to a decline in cardiac function among post-operative patients. Our primary objective is to identify the changes of cardiac function to post-TEVAR patients at rest using echocardiography studies. With this knowledge, we aim to gain valuable insight into the post-op management of patients with the goal of strategizing post-op care to reduce complications and exacerbation to heart failure.
b. Methods: Chart review of the electronic medical record (EMR) was used to collect patient data, patient history, procedural information, outcomes, and echocardiogram parameters. To assess the impact of TEVAR, the echo parameters were then analyzed using a paired sample t-test, comparing pre-TEVAR and post-TEVAR echocardiograms. The alpha level for determining statistical significance was set at p=0.05 for two-sided comparisons.
c. Results: Between the pre-TEVAR echo and first post-op echo, average indexed left atrial volume for all patients (n=30) was 35.68 pre-TEVAR and increased to 35.75 post-TEVAR with a p-value of 0.97. Mitral E/A ratio decreased from 1.09 pre-operatively to 1.04 post-operatively. E/A ratio (n=29) with a p-value of 0.92. Average E/e’ ratio increased from 10.59 pre-TEVAR to 10.69 post-TEVAR (n=32) with a p-value of 0.91. Tricuspid regurgitation pressure gradient (TRPG) increased from 24.02 pre-operatively to 26.96 post-operatively (n=22) with a p-value of 0.33. Between the pre-TEVAR echo and second post-op echo, the indexed left atrial volume increased on average by 3.62 after TEVAR (p=0.66). E/A ratio decreased by 0.03 across all patients on average (p=0.66), while E/e’ ratio decreased by 0.25 post-operatively (p=0.31). TRPG increased by 0.92 after TEVAR (p=0.84).
d. Conclusions: The data showed a slight upwards trend in TRPG after the first post-op echo. However, no statistically significant changes to diastolic function were seen in patients after TEVAR.
Recommended Citation
Kassam, Nabeel, "Effects Of Thoracic Endovascular Aortic Repair On Cardiac Function At Rest" (2024). Yale Medicine Thesis Digital Library. 4247.
https://elischolar.library.yale.edu/ymtdl/4247
Comments
This is an Open Access Thesis.