Endovascular repair of the thoracic aorta: predictors of 30-day mortality in patients on the New Zealand Thoracic Aortic Stent Database (NZ TAS).

OBJECTIVES: To evaluate data in the New Zealand Thoracic Aortic Stent database to try and identify a scoring system that could predict 30-day mortality in patients undergoing stenting of the descending thoracic aorta (TEVAR).

DESIGN: Retrospective analysis of the New Zealand thoracic aortic stent database between December 2001 and August 2007.

MATERIALS AND METHODS: The 30-day mortality of the 122 patients is 7.38% (n=9). Risk factors were recorded based on the Society of Thoracic Surgeons (STS) risk score. Glasgow aneurysm score was calculated and the pathology being treated analysed. Univariate analysis was carried out.

RESULTS: The mortality of three pathology groups was compared. 30-day mortality was 2.04% (n=1) in the elective aneurysm group, 17.95% (n=7) in the complicated Stanford type B dissection group, and 0% (n=0) in the trauma group. Thirty-day mortality is significantly higher in the dissection group compared with the elective aneurysm (p=0.02) and trauma (p=0.03) groups. The most frequent risk factors in the dissection group of patients were peripheral vascular disease, smoking and hypertension. Although percentage mortality is higher with increasing GAS, the results are not statistically significant (p=0.34). No independent risk factors were identified from the STS risk score data.

CONCLUSION: No specific risk score system seems to be able to predict mortality in TEVAR patients.