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The following is a summary of “Engineering approach to study the effect of TEVAR on the cardiovascular system: A systematic review,” published in the March 2025 issue of the Annals of Vascular Surgery by Magliocco et al.

Thoracic Endovascular Aortic Repair (TEVAR) is widely utilized for treating thoracic aortic pathologies; however, its impact on cardiac geometry, hemodynamics, and vascular biomechanics remains an area of ongoing investigation. This study aimed to analyze the effects of TEVAR on cardiac remodeling by evaluating changes in left ventricular mass, flow dynamics, and biomechanical stress distribution. 

The focus was on pre- and post-treatment assessments of left ventricular mass variations and fluid dynamics parameters, including Wall Shear Stress (WSS), flow distribution, and velocity changes. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale to ensure methodological rigor. A total of eleven studies met the inclusion criteria. Among these, three studies examined left ventricular mass alterations, five reported variations in flow and velocity, and six analyzed changes in WSS. Considerable heterogeneity was noted in the methodologies and analytical approaches used across the studies, leading to discrepancies in reported findings. Despite this variation, a general trend emerged, indicating an increase in left ventricular mass following TEVAR. 

Additionally, improvements in flow dynamics and biomechanical stress were observed after the exclusion of the diseased aortic segment, suggesting a positive impact on vascular function. These findings highlight the potential influence of TEVAR on cardiovascular remodeling, yet the current body of literature remains limited, with inconsistencies in study designs, target pathologies, and follow-up durations. The integration of computational simulations and advanced engineering analyses into clinical practice requires the establishment of standardized assessment protocols to enhance reliability and comparability across studies. Future research should focus on harmonizing methodologies and expanding patient cohorts to better elucidate the long-term cardiovascular effects of TEVAR and optimize post-treatment monitoring strategies.

Source: annalsofvascularsurgery.com/article/S0890-5096(25)00090-1/fulltext