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.

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This is an Open Access Thesis.

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