The impact of thoracic aortic endograft explant on open descending and thoracoabdominal aortic replacement

Objective: Thoracic endovascular aortic repair (TEVAR) has become the primary treatment for descending thoracic aortic aneurysms and complicated acute type B aortic dissections. Consequently, a significant cohort of patients experience endograft failure or infection requiring open surgical explant. This study evaluated the impact of TEVAR explant on open descending (DTA) or thoracoabdominal aortic (TAA) replacement. Methods: Between January 2006 and January 2025, 442 adult patients underwent open DTA or TAAA repair at a single institution, among whom 68 patients (15%) had a previous TEVAR and underwent TEVAR explant (EXPLANT) at time of surgery. Results: = .10). Conclusions: TEVAR explant for aneurysm expansion does not impact outcomes after open DTA or TAA aneurysm repair. However, explant of infected thoracic endografts typically requires circulatory arrest and is associated with increased mortality.