endovascular aortic aneurysm and dissection repair (evar) in iran: descriptive midterm follow-up results

Background: endovascular repair of aorta in comparison to open surgery has a low early operative mortality rate, but its long-term results are uncertain. objectives: the current study describes for the first time our initial four-year experience of elective endovascular aortic repair (evar) at tehran heart center, the first and a major referral heart center in iran, as a pioneer of evar in iran. patients and methods: a total of 51 patients (46 men) who had the diagnosis of either an abdominal aortic aneurysm (aaa) (n = 36), thoracic aortic aneurysm (taa) (n = 7), or thoracic aortic dissection (tad) (n = 8) who had undergone evar by medtronic stent grafts by our team between december 2006 and june 2009 were reviewed.results: the rate of in-hospital aneurysm-related deaths in the group with aaa stood at 2.8% (one case), while there was no in-hospital mortality in the other groups. all patients were followed up for 13-18 months. the cumulative death rate in follow-up was nine cases from the total 51 cases (18%), out of which six cases were in the aaa group (four patients due to non-cardiac causes and two patients due to aneurysm- related causes), one case in the taa group (following a severe hemoptysis), and two cases in the tad group (following an expansion of dissection from re-entrance). the major event-free survival rate was 80.7% for endovascular repair of aaa, 85.7% for endovascular repair of taa, and 65.6% for endovascular repair of tad. conclusion: the endovascular stent-graft repair of the abdominal and thoracic aortic aneurysm and aortic dissection had high technical success rates in tandem with low-rate early mortality and morbidity, short hospital stay, and acceptable mid-term free symptom survival among iranian patients.