• Chest · Mar 2014

    Postthoracic endovascular aortic stenting pyrexia: prevalence and implications.

    • Song Wan, Rainbow Lau, Innes Wan, and Simon Chow.
    • Chest. 2014 Mar 1;145(3 Suppl):45A.

    Session TitleThoracic Surgery PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: To study the prevalence of post-operative pyrexia after thoracic endovascular aortic repair ( TEVAR ) and discuss the appropriate management.MethodsWe 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.ResultsA 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.ConclusionsPost TEVAR pyrexia is common and its clinical course is benign. Antibiotics therapy is unlikely helpful unless in patients with positive cultures.Clinical ImplicationsCautious use of antibiotics is recommended in post TEVAR pyrexia.DisclosureThe following authors have nothing to disclose: Randolph Wong, Calvin Ng, Rainbow Lau, Micky Kwok, Simon Chow, Innes Wan, Song Wan, Simon Yu, Malcolm UnderwoodNo Product/Research Disclosure Information.

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