{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T05:10:04Z","timestamp":1779426604885,"version":"3.53.1"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S104795112510958X_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Contemporary management of aortic coarctation in adults is primarily by percutaneous intervention; however, this is not always possible. Intrapericardial ascending-to-descending aortic grafting is an alternative approach in adults with complex aortic coarctation. It can be performed off-pump and allows for a simultaneous treatment of concomitant cardiac lesions. Our aim was to examine the indications and the clinical long-term outcomes of intrapericardial ascending-to-descending aortic grafting in adults with aortic coarctation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112510958X_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed demographic, clinical, surgical, and follow-up data of patients who underwent intrapericardial ascending-to-descending aortic grafting at a single tertiary centre between September 1994 and November 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112510958X_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Ten patients were identified. Indications were primary intervention (\n                      <jats:italic>n<\/jats:italic>\n                      = 4), re-coarctation (\n                      <jats:italic>n<\/jats:italic>\n                      = 5), and iatrogenic coarctation of aorta after stent grafting (\n                      <jats:italic>n<\/jats:italic>\n                      = 1). There were no peri-operative deaths. During a mean follow-up of 13.6 \u00b1 9.4 years, one patient died 11 years after surgery, unrelated to intrapericardial ascending-to-descending aortic grafting. All grafts remained patent with no anastomotic pseudoaneurysms at latest follow-up.\n                    <\/jats:p>\n                    <jats:p>\n                      The mean systolic blood pressure decreased from 154 \u00b1 24 mmHg at baseline to 134 \u00b1 20 mmHg at latest follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.05), with the mean number of prescribed antihypertensive medications decreasing from 2.8 \u00b1 1.5 preoperatively to 1.6 \u00b1 0.5 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.11).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112510958X_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Intrapericardial ascending-to-descending aortic grafting is a safe and effective approach for adults with complex coarctation of aorta or re-coarctation not suitable for a percutaneous or conventional surgical approach. Improved blood pressure control and reduced anti-hypertensive use were observed long-term.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s104795112510958x","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T07:02:10Z","timestamp":1758524530000},"page":"2093-2097","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Ascending-to-descending aortic grafting: an alternative approach for adults with complex aortic coarctation"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6923-2315","authenticated-orcid":false,"given":"Polona","family":"Kacar","sequence":"first","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019s NHS Foundation Trust"},{"name":"University Medical Centre Ljubljana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Iannaccone","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St 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