Expert review of cardiovascular therapy · 2026
Complications associated with thoracic endovascular aortic repair: highlighting the role of peri- and post-operative cardiac monitoring.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Xanthopoulos Andrew, Androutsopoulou Vasiliki, Zotos Prokopis-Andreas, Giamouzis Grigorios, Skoularigis John, Magouliotis Dimitrios E
Аннотация
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) is first-line therapy for most descending thoracic aortic pathologies, yet it is performed in patients with a heavy burden of coronary disease, hypertension and limited cardiac reserve, and its cardiac complications remain underemphasized relative to neurological and device-related events.
AREAS COVERED: We summarize the complication profile of TEVAR briefly and then concentrate on its cardiac dimension: myocardial injury after non-cardiac surgery, arrhythmia, acute heart failure, and the chronic ventricular consequences of stent-graft-induced aortic stiffening. We review the mechanisms linking endograft deployment to ventricular-arterial uncoupling, the echocardiographic markers of interest, blood pressure management, and a phase-based framework for peri- and post-operative cardiac monitoring, distinguishing guideline-supported recommendations from expert opinion and from evidence extrapolated from general vascular surgery. PubMed/MEDLINE were searched from database inception to August 2026.
EXPERT OPINION: Cardiac surveillance around TEVAR is inconsistent and largely informal. We argue for baseline echocardiography in all elective patients, protocolized high-sensitivity troponin and natriuretic peptide measurement, defined-duration rhythm monitoring, structured blood pressure control, and longitudinal assessment of ventricular-arterial coupling within a heart-team pathway. TEVAR-specific outcome data and Windkessel-preserving graft design are the priorities for the next phase of endovascular aortic care.
AREAS COVERED: We summarize the complication profile of TEVAR briefly and then concentrate on its cardiac dimension: myocardial injury after non-cardiac surgery, arrhythmia, acute heart failure, and the chronic ventricular consequences of stent-graft-induced aortic stiffening. We review the mechanisms linking endograft deployment to ventricular-arterial uncoupling, the echocardiographic markers of interest, blood pressure management, and a phase-based framework for peri- and post-operative cardiac monitoring, distinguishing guideline-supported recommendations from expert opinion and from evidence extrapolated from general vascular surgery. PubMed/MEDLINE were searched from database inception to August 2026.
EXPERT OPINION: Cardiac surveillance around TEVAR is inconsistent and largely informal. We argue for baseline echocardiography in all elective patients, protocolized high-sensitivity troponin and natriuretic peptide measurement, defined-duration rhythm monitoring, structured blood pressure control, and longitudinal assessment of ventricular-arterial coupling within a heart-team pathway. TEVAR-specific outcome data and Windkessel-preserving graft design are the priorities for the next phase of endovascular aortic care.