COMPARATIVE ANALYSIS OF QUALITY OF LIFE AFTER THORACIC ENDOVASCULAR AORTIC REPAIR AND OPTIMAL MEDICAL THERAPY IN PATIENTS WITH UNCOMPLICATED TYPE B AORTIC DISSECTION

Introduction. Thoracic endovascular aortic repair (TEVAR) is considered a minimally invasive intervention, but the impact of this intervention on quality of life has not yet been fully evaluated. Aim. To analyze patient quality of life and compare outcomes between patients treated with TEVAR in combination with optimal medical therapy versus optimal medical therapy alone. Materials and methods. The retrospective study included adult patients (over 18 years old) who were hospitalized at the State Institution "Heart Institute of the Ministry of Health" between 2018 and 2024 due to dissection of the descending thoracic aorta. Depending on the method of treatment for uncomplicated type B aortic dissection. All patients were divided into two groups: group A – patients who were initially prescribed TEVAR with optimal medical therapy (OMT) and group B – patients who were initially prescribed OMT. Quality of life was assessed using the SF-36 questionnaire. Results. The value of the mental component according to the SF-36 questionnaire at the 3rd year of observation was not significantly different between the study groups (47.0 (39.5; 55.5) points vs. 38 (30.0; 41.0), p=0.093). Patients of group A had significantly higher total values of the physical component of quality of life compared to group B (51.0 (41.5; 54.5) points versus 42.0 (38.0; 47.0) points, p=0.032 ), while patients of group A were characterized by significantly higher values of the parameter "Physical functioning" (59.5; 75.0) points versus 64 (51.0; 68.0) points, p=0.043 and "Pain" (89 ( 71.5;95) points against 77(61.0;91.0) points, p=0.038) in comparison with patients of group B. On the basis of multivariate regression, three independent factors influencing the physical component were established – the presence in the anamnesis of patients with arterial hypertension of the 3rd degree (p=0.021), chronic renal failure (p=0.039) and low adherence to medication (p=0.033) and two independent factors influencing the mental component of quality of life – the presence of arterial hypertension of the 3rd degree in the patient's anamnesis (p=0.011) and the need for intervention on the aorta during the observation period (p=0.021). Conclusions. TEVAR is safe and effective in patients with type B aortic dissection with favorable clinical and quality-of-life outcomes.