SESSION TITLE: Thoracic Surgery Posters
SESSION TYPE: Poster Presentations
PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM
PURPOSE: To study the prevalence of post-operative pyrexia after thoracic endovascular aortic repair ( TEVAR ) and discuss the appropriate management.
METHODS: We conducted a retrospective review on patients underwent TEVAR in our institution from 2008 to 2013. Patients’ demographics, operative procedures, post-operative complications including bleeding, stroke, paraplegia and fever (> 38oC) and mortality were recorded. For patients with fever, onset of fever from the time of operation, white cell count (WCC), C-reactive protein values and presence of positive microbiological cultures were recorded.
RESULTS: A total of 73 patients received TEVAR during the study period. The overall mortality is zero. There were 6 patients with total aortic debranching, 34 patients with extra-anatomical bypass of head and neck vessels to facilitate TEVAR. Two patients developed post-operative bleeding requiring re-exploration. Three patients developed minor stroke and 2 patients developed paraplegia that resolved after CSF drainage. Post-operative pyrexia were present in 75% of patients and only 3% of patient had positive microbiological cultures ( 2 from sputum and 1 from urine ). Increase in WCC and CRP were observed in 70% of patient which peak on day 3 after TEVAR. None of our patients developed significant sepsis that required escalating inotropes or upgrading antiobiotics.
CONCLUSIONS: Post TEVAR pyrexia is common and its clinical course is benign. Antibiotics therapy is unlikely helpful unless in patients with positive cultures.
CLINICAL IMPLICATIONS: Cautious use of antibiotics is recommended in post TEVAR pyrexia.
DISCLOSURE: The following authors have nothing to disclose: Randolph Wong, Calvin Ng, Rainbow Lau, Micky Kwok, Simon Chow, Innes Wan, Song Wan, Simon Yu, Malcolm Underwood
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