Increased Pulse Wave Velocity and Arterial Hypertension in Young Patients With Thoracic Aortic Endografts

Background: Hypertension after thoracic endovascular aortic repair (TEVAR) is a medical complication not widely investigated. The aim of the study was to test the hypothesis that TEVAR in young patients suffering from thoracic aortic transection alters pulse wave velocity (PWV) and reflected wave velocity and induces arterial hypertension. Methods: The data concerning 11 young patients (all men with a mean age of 26.9 years [range: 18-33]) treated with TEVAR for thoracic aortic transection were retrospectively collected and analyzed. PWV, systolic blood pressure (SBP), and pulse pressure (PP) were evaluated and compared with those recorded in 11 healthy young individuals matched for age and gender. Results: Nine patients had postoperative arterial hypertension after TEVAR, and four had durable hypertension during the follow-up period (13-66 months after TEVAR). The SBP, the PP, and the PWV of the patients were greater compared with those of the control group (SBP: 134.1 +/- 13.7 vs. 121.36 +/- 7.1 mm Hg, P = 0.016; PP: 60.45 +/- 19.42 vs. 44.1 +/- 4.37, P = 0.020; and PWV: 10.41 +/- 2.85 vs. 7.45 +/- 0.66 m/sec, P = 0.006). Conclusions: Aortic endografts could produce a discontinuation of the pulsatile waves with a subsequent increase of aortic PWV. Increased PWV is an important risk factor for future cardiovascular events and should be evaluated in all patients after TEVAR.