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Department of Cardiothoracic and Vascular Surgery 1 School of Public Health 2

An Outcome Analysis of Endovascular vs . Open Repair of Blunt Traumatic Aortic Injuries. A. Azizzadeh MD 1 , K.M. Charlton - Ouw MD 1 Z. Chen MD 1 , A.L. Estrera MD 1 , S.M. Coogan MD 1 , M.H. Rahbar PhD 2 , H.J. Safi MD 1. Department of Cardiothoracic and Vascular Surgery 1

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Department of Cardiothoracic and Vascular Surgery 1 School of Public Health 2

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  1. An Outcome Analysis of Endovascular vs. Open Repair of Blunt Traumatic Aortic Injuries A. AzizzadehMD1,K.M. Charlton-OuwMD1Z. Chen MD1,A.L. Estrera MD1,S.M. CooganMD1,M.H. RahbarPhD2, H.J. Safi MD1 Department of Cardiothoracic and Vascular Surgery1 School of Public Health2 The University of Texas Medical School at Houston Memorial Hermann Heart & Vascular Institute

  2. Purpose To evaluate the outcomes of TEVAR vs. OR for pts with TAI

  3. Methods • From 4/2002 to 6/2010 • Urban level 1 trauma center • Prospectively collected data from the institutional trauma registry • Retrospective review of hospital financial accounts Primary: • Mortality (In-Hospital) • Complications Secondary: • Cost • Intensive care unit (ICU) LOS • Pre-operative LOS • Post-operative LOS • Total hospital LOS

  4. Results • 4/ 2002 to 6/ 2010 • 106 patients with TAI 74 32 • Mean Age: 36.4 yrs

  5. Baseline Characteristics

  6. Operative Data Open Repair: • N=56 • Tech Success: 98.2% • Operative Mortality: 0% TEVAR: • N=50 • Tech Success: 100% • Operative Mortality: 0% • Devices (N=52) • TAG (WL Gore), N=33 • Talent (Medtronic), N=18 • Other (WL Gore), N=1

  7. Primary Outcomes

  8. Cost Length of Stay

  9. TEVAR Follow Up Imaging Protocol • CTA • 1 month • 6 months • 12 months • Yearly • Compliance 32%

  10. Survival Distribution

  11. Conclusion • OR pts 3x more likely to have complications or mortality • The cost of TEVAR was NOT significantly different than OR • Findings support use of TEVAR for pts with TAI

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