{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T23:04:33Z","timestamp":1780009473807,"version":"3.53.1"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"name":"Shanghai Qingpu Borough Health System","award":["TZ2023-13"],"award-info":[{"award-number":["TZ2023-13"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to evaluate the safety and durability of transcatheter closure of anastomotic leak (AL) after ascending aortic (AAo) surgery.<\/jats:p>\n                  <jats:p>From 2016 to 2021, we performed transcatheter closure for 22 patients aged 56.9\u2009\u00b1\u200912 years (19 male, 86.4%) who sustained anastomotic leak in the ascending aorta (AAoAL) after AAo surgery. Access and device were selected according to the presence of a patent Cabrol (perigraft-to-right atrium) shunt (n\u2009=\u200916, 72.7%) and leak size.<\/jats:p>\n                  <jats:p>Fifteen patients had tricuspid regurgitation (TR; 68.2%), 13 were symptomatic (59.1%), and 11 were in the New York Heart Association (NYHA) functional class III\/IV (50%). Mean AAoAL diameter was 3.3\u2009\u00b1\u20091.5\u2009mm. Mean procedural time was 141\u2009\u00b1\u200953\u2009minutes. Procedural success rate was 86.4% (19\/22, 14 with Cabrol shunt). AAoAL was directly closed or coiled in 12 patients. Follow-up was complete in 100% at a mean duration of 4.9\u2009\u00b1\u20091.1 years (range 3.6\u20138.1). All patients were alive, and two underwent reoperation. Freedom from death and reoperation was 94.7% at 2 years and 89.5% through 8 years. AAoAL was obliterated in 11, while a trace residual shunt was seen in 8 patients. The aorta at the leak shrank significantly in all (49.1\u201341.4\u2009mm, p\u2009=\u20090.010). Patients with Cabrol shunt showed a significant shrinkage of the right atrium (46.9\u2009\u00b1\u20098.8\u2009mm vs. 39.1\u2009\u00b1\u20098.2\u2009mm, p\u2009=\u20090.030) and right ventricle (41.4\u2009\u00b1\u20094.7\u2009mm vs. 30.4\u2009\u00b1\u20096.2\u2009mm, p\u2009&lt;\u20090.001), along with improved heart function (NYHA class III 4\/12, IV 5\/12 vs. class III 4\/12, IV 0\/12, p\u2009=\u20090.032) and alleviation of TR (moderate 6\/14, severe 3\/14 vs. moderate 2\/14, severe 1\/14, p\u2009=\u20090.081).<\/jats:p>\n                  <jats:p>Transcatheter closure may be a feasible, safe, and effective approach to anastomotic leak after ascending aortic surgery in selected patients, which can achieve favorable short- to midterm outcomes.<\/jats:p>","DOI":"10.1055\/a-2641-6468","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T19:16:37Z","timestamp":1750792597000},"page":"296-304","source":"Crossref","is-referenced-by-count":0,"title":["Midterm Outcomes of Transcatheter Closure of Anastomotic Leak after Ascending Aortic Surgery"],"prefix":"10.1055","volume":"74","author":[{"given":"Cheng-Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology, DeltaHealth Hospital Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3873-0837","authenticated-orcid":false,"given":"Wei-Guo","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, DeltaHealth Hospital Shanghai, Shanghai, China"},{"name":"Division of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, DeltaHealth Hospital Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, DeltaHealth Hospital Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Liang","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Radiology, DeltaHealth Hospital Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian-Jun","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, DeltaHealth Hospital Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Zhong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, DeltaHealth Hospital Shanghai, Shanghai, China"},{"name":"Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1024\/0301-1526\/a000644","article-title":"Anastomotic leak after surgical repair of type A aortic dissection - prevalence and consequences in midterm follow-up","volume":"46","author":"T Ghazy","year":"2017","journal-title":"Vasa"},{"issue":"03","key":"ref2","first-page":"292","article-title":"Extended repair for acute type A aortic dissection: long-term outcomes of the frozen elephant trunk technique beyond 10 years","volume":"61","author":"W G Ma","year":"2020","journal-title":"J Cardiovasc Surg 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Surg"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.jaccas.2020.11.007","article-title":"Percutaneous closure of iatrogenic ascending aortic pseudoaneurysms following surgical aortic repair","volume":"3","author":"J Stehli","year":"2021","journal-title":"JACC Case Rep"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jaccas.2022.01.005","article-title":"Transcatheter treatment of ascending aorta pseudoaneurysm guided by 3D-model technology","volume":"4","author":"G Santoro","year":"2022","journal-title":"JACC Case Rep"},{"issue":"11","key":"ref34","doi-asserted-by":"crossref","first-page":"ytad516","DOI":"10.1093\/ehjcr\/ytad516","article-title":"A case report of transcatheter closure of post-Bentall ascending aortic pseudoaneurysm due to coronary button dehiscence","volume":"7","author":"H C Lin","year":"2023","journal-title":"Eur Heart J Case Rep"},{"issue":"05","key":"ref35","first-page":"642","article-title":"Sun's procedure for complex aortic arch repair: total arch replacement using a tetrafurcate graft with stented elephant trunk implantation","volume":"2","author":"W G Ma","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"issue":"02","key":"ref36","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1161\/01.CIR.78.2.361","article-title":"Transcatheter closure of ventricular septal defects","volume":"78","author":"J E Lock","year":"1988","journal-title":"Circulation"}],"container-title":["The Thoracic and Cardiovascular 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