1. Aortic Symposium 2012 Short Term Outcomes in Endovascular and Open Repair of Thoracic Aortic Aneurysms Are Controversial Through NSQIP Alexander I. Kraev, MD Andrew Nguyen, MD R Anthony Perez-Tamayo, MD PhD Gregg Landis, MD

2. Aortic Symposium 2012 National Surgical Quality Improvement Program (NSQIP) Administered by the American College of Surgeons –Join Commission Surgical Care Improvement Project 400 Centers participating across United States –Teaching and non-teaching hospitals 136 Perioperative variables measured –Preoperative risk factors –Intraoperative variables –30-day post-op morbidity and mortality outcomes

3. Aortic Symposium 2012 TEVAR Thoracic Endovascular Aneurysm Repair –Minimally invasive option to the traditional open repair Initial experience at specialty institutions –Highly favorable towards TEVAR Currently widely adopted across the country –Prospective and long-term studies are lacking

4. Aortic Symposium 2012 NSQIP 2005-2009 Database 12162 total aortic cases –7374 endovascular repairs –4788 open repairs ElectiveEmergencyTotal Open Repair 10216118 TEVAR 635128763 Total 737144881

5. Aortic Symposium 2012 NSQIP Database

6. Aortic Symposium 2012 Descriptive Statistics TEVAROpen P-value Age (years) 68.567.6.54 Male % 59.762.7.55 Op Time (min) 170.2233.8 <.0001 Anesth Time (min) 272.2338.2 <.0001 Return to OR (yes %) 12.3%13.6%.66 ASA III/IV (%) 94.690.7.58 Emergency (%) 16.713.6.38 LOS (days) 7.410.8 <.001

7. Aortic Symposium 2012 TEVAR vs Open Mortality

8. Aortic Symposium 2012 TEVAR vs Open: Cardiac Outcomes Combined end-point of cardiac arrest or acute myocardial infarction

9. Aortic Symposium 2012 TEVAR vs Open: Pulmonary Outcomes Combined end-point of prolonged intubation, re-intubation, pulmonary embolism, or pneumonia

10. Aortic Symposium 2012 TEVAR vs Open: Renal Outcomes Combined end-point of acute renal insufficiency or acute renal failure

11. Aortic Symposium 2012 TEVAR vs Open: Post-Operative Stroke

12. Aortic Symposium 2012 Conclusion Short term mortality of TEVAR and open repair are equivalent Operative time, anesthesia time, and length of stay are shorter in TEVAR Pulmonary and renal outcomes are superior in TEVAR Stroke rate is higher in TEVAR