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Mid- and long-term outcomes of thoracic endovascular aortic repair in acute and subacute uncomplicated type B aortic dissection
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  • Matti Jubouri,
  • Mohammed Al-Tawil,
  • Ho Cheung Anthony Yip,
  • Ali Bashir,
  • Sven Zhen Cian Patrick Tan,
  • Mohamad Bashir,
  • Richard Anderson,
  • Damian Bailey,
  • Christoph Nienaber,
  • Joseph Coselli,
  • Ian Williams
Matti Jubouri
Hull York Medical School

Corresponding Author:[email protected]

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Mohammed Al-Tawil
Al Quds University Faculty of Medicine
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Ho Cheung Anthony Yip
St George's University of London
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Ali Bashir
Carol Davila University of Medicine and Pharmacy Faculty of General Medicine
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Sven Zhen Cian Patrick Tan
Queen Mary University of London Barts and The London School of Medicine and Dentistry
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Mohamad Bashir
NHS Wales Health Education and Improvement Wales
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Richard Anderson
University Hospital of Wales
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Damian Bailey
University of South Wales Faculty of Life Sciences and Education
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Christoph Nienaber
Royal Brompton and Harefield Hospitals
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Joseph Coselli
Baylor College of Medicine Michael E DeBakey Department of Surgery
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Ian Williams
University Hospital of Wales
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Background: Uncomplicated type B aortic dissection (un-TBAD) has been managed conservatively with medical therapy in order to control the heart rate and blood pressure to limit disease progression, in addition to radiological follow-up. However, several trials and observational studies have investigated the use of thoracic endovascular aortic repair (TEVAR) in un-TBAD and suggested that TEVAR provides a survival benefit over medical therapy. Outcomes of TEVAR have also been linked with the timing of intervention. Aims: The scope of this review is to collate and summarise all the evidence in the literature on the mid- and long-term outcomes of TEVAR in un-TBAD, confirming its superiority. We also aimed to investigate the relationship between timing of TEVAR intervention and results. Methods: We carried out a comprehensive literature search on multiple electronic databases including PubMed, Scopus and EMBASE in order to collate and summarise all research evidence on the mid- and long-term outcomes of TEVAR in un-TBAD, as well as its relationship with intervention timing. Results: TEVAR has proven to be a safe and effective tool in un-TBAD, offering superior mid- and long-term outcomes including all-cause and aorta-related mortality, aortic-specific adverse events, aortic remodelling, and need for reintervention. Additionally, performing TEVAR during the subacute phase of dissection seems to yield optimal results. Conclusion: The evidence demonstrating a survival advantage in favour TEVAR over medical therapy in un-TBAD means that with further research, particular trials and observational studies, TEVAR could become the gold-standard treatment option for un-TBAD patients.
22 Jan 2022Submitted to Journal of Cardiac Surgery
24 Jan 2022Submission Checks Completed
24 Jan 2022Assigned to Editor
24 Jan 2022Reviewer(s) Assigned
27 Jan 2022Review(s) Completed, Editorial Evaluation Pending
28 Jan 2022Editorial Decision: Accept
May 2022Published in Journal of Cardiac Surgery volume 37 issue 5 on pages 1328-1339. 10.1111/jocs.16349