Endovascular aortic repair is associated with greater hemodynamic stability compared with open aortic reconstruction

Objective: Examination of overall hemodynamic stability in patients undergo ing endovascular aortic repair (EAR) compared with open aortic repair (OAR) . Design: Retrospective study. Setting: University hospital setting. Participants: Seventy-two patients undergoing OAR and 17 patients undergoin g EAR were studied. Interventions: None. Measurements and Main Results: Physiologic parameters were extracted every 15 seconds from computerized anesthesia records. Median values were calcula ted for every 2-minute epoch, and the absolute value of the fractional chan ge in median (\FCM\) from epoch to epoch was calculated for a maximum of 5 hours during the intraoperative period. The incidence of extremes in hemody namic parameters was compared. Data are presented as median and interquarti le ranges. The frequency of \FCM\ greater than 0.06 for mean arterial press ure (MAP) was significantly greater in the OAR compared with the EAR group (0.37 [0.30, 0.46] vs 0.14 [0.11, 0.21], p < 0.0001), implying greater stab ility in MAP during EAR. Similarly, the mean pulmonary artery pressures (MP APs) were significantly more stable during EAR compared with OAR (frequency of \FCM\ > 0.07: EAR, 0.20 [0.16, 0.27] vs OAR, 0.32 [0.26, 0.39]; p < 0.0 1). No intergroup differences were detected in heart rate (HR), systolic (S PAP) or diastolic pulmonary artery pressures (DPAP), or central venous pres sures (CVPs). With the exception of a greater incidence of low CVP during E AR, there were no significant differences in the frequency of extremes of h emodynamic values between groups. Conclusion: These results show improved hemodynamic stability during EAR co mpared with OAR. Copyright (C) 1999 by W.B. Saunders Company.