{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:45:47Z","timestamp":1791935147058,"version":"4.3.4"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Baylor College of\n                        Medicine","award":["T32HL139430"],"award-info":[{"award-number":["T32HL139430"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aorta (Stamford)"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Total transverse aortic arch replacement is a complex operation performed to\n                        address aortic aneurysm with and without chronic aortic dissection. To\n                        predict 90-day survival after this procedure, we created a holistic tool for\n                        predicting postoperative mortality in patients who undergo total arch repair\n                        (TAR): the Aortic Arch Operation Risk Tool for Assessment (AAORTA)\n                        score.<\/jats:p>\n                  <jats:p>Univariate and multivariate analyses were performed on data from patients\n                            (N=470; 243 with nondissecting aneurysm, 227 with chronic Type A\n                        dissection) who underwent TAR at a high-volume practice between April 2006\n                        and November 2024. Regression analysis identified variables to be used in\n                        the AAORTA score. The predictive performance of the score was assessed with\n                        the area under the receiver operating characteristic curve (AUROCC), Brier\n                        score, and linear fitting.<\/jats:p>\n                  <jats:p>Of 470 patients who underwent TAR, 65 (13.8%) died within 90 days of repair.\n                        The AAORTA score relied on five preoperative variables: heritable thoracic\n                        aortic disease, prior coronary artery bypass grafting (CABG), kidney\n                        disease, pulmonary disease (restrictive or obstructive), and no history of\n                        smoking. Previous CABG was the strongest predictor of 90-day mortality. The\n                        AAORTA score had an AUROCC of 0.784, a Brier score of 0.105, and a\n                        goodness-of-fit R\n                  2 of 0.954.<\/jats:p>\n                  <jats:p>The AAORTA score can accurately stratify 90-day mortality risk in patients\n                        who undergo elective TAR, using only five variables easily acquired during\n                        standard preoperative evaluation. This score could be used to aid\n                        preoperative counseling with patients and families. Prospective multicenter\n                        validation will help establish its generalizability.<\/jats:p>","DOI":"10.1055\/a-2965-6246","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:07:11Z","timestamp":1791932831000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Preoperative Risk-assessment Score for Elective Total Aortic Arch\n                    Repair: AAORTA Risk Tool"],"prefix":"10.1055","volume":"14","author":[{"given":"Michael Tyler","family":"Guinn","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"Rice University, Texas, United States","place":["Houston"],"department":["Department of Bioengineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis J.","family":"Miles","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica A.","family":"Glover","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Office of Surgical Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan Y.","family":"Green","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Office of Surgical Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynna H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Office of Surgical Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginger M.","family":"Etheridge","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Office of Surgical Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren K.","family":"Barron","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"CHI St Luke\u2019s Health\u2014Baylor St Luke\u2019s Medical Center, Texas, United States","place":["Houston"],"department":["Department of Cardiovascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna H.","family":"Xue","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"CHI St Luke\u2019s Health\u2014Baylor St Luke\u2019s Medical Center, Texas, United States","place":["Houston"],"department":["Department of Cardiovascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Orozco-Sevilla","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"CHI St Luke\u2019s Health\u2014Baylor St Luke\u2019s Medical Center, Texas, United States","place":["Houston"],"department":["Department of Cardiovascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhasis","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"CHI St Luke\u2019s Health\u2014Baylor St Luke\u2019s Medical Center, Texas, United States","place":["Houston"],"department":["Department of Cardiovascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R.","family":"Moon","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"CHI St Luke\u2019s Health\u2014Baylor St Luke\u2019s Medical Center, Texas, United States","place":["Houston"],"department":["Department of Cardiovascular Surgery"]},{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Cardiovascular Research Institute"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2176-5988","authenticated-orcid":false,"given":"Joseph S.","family":"Coselli","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery"]},{"name":"CHI St Luke\u2019s Health\u2014Baylor St Luke\u2019s Medical Center, Texas, United States","place":["Houston"],"department":["Department of Cardiovascular Surgery"]},{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"],"department":["Cardiovascular Research Institute"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/ctr.12181","article-title":"The survival outcomes following liver transplantation (SOFT) score: validation\n                    with contemporaneous data and stratification of high-risk cohorts","volume":"27","author":"A Rana","year":"2013","journal-title":"Clin Transplant"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.healun.2013.02.001","article-title":"Validation of the United States-derived Index for Mortality Prediction After\n                    Cardiac Transplantation (IMPACT) using international registry data","volume":"32","author":"A Kilic","year":"2013","journal-title":"J Heart Lung Transplant"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1053\/he.2000.5852","article-title":"A model to predict poor survival in patients undergoing transjugular\n                    intrahepatic portosystemic shunts","volume":"31","author":"M Malinchoc","year":"2000","journal-title":"Hepatology"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/j.healun.2023.06.009","article-title":"A new method for classifying prognostic risk factors in lung transplant\n                    candidates","volume":"42","author":"C J Lehr","year":"2023","journal-title":"J Heart Lung Transplant"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1093\/ejcts\/ezy001","article-title":"Modified predictive score based on frailty for mid-term outcomes in open total\n                    aortic arch surgery","volume":"54","author":"A Hiraoka","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"issue":"06","key":"ref6","first-page":"657","article-title":"Successful resection of fusiform aneurysm of aortic arch with replacement by\n                    homograft","volume":"105","author":"M E De Bakey","year":"1957","journal-title":"Surg Gynecol Obstet"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.xjtc.2021.05.011","article-title":"Total arch replacement: technical pearls","volume":"10","author":"I Gambardella","year":"2021","journal-title":"JTCVS Tech"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.athoracsur.2022.12.016","article-title":"Contemporary midterm outcomes after primary repair of chronic type A aortic\n                    dissection","volume":"116","author":"R Zea-Vera","year":"2023","journal-title":"Ann Thorac Surg"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jtcvs.2024.01.035","article-title":"Unplanned readmissions, community socioeconomic factors, and their effects on\n                    long-term survival after complex thoracic aortic surgery","volume":"169","author":"O Preventza","year":"2025","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"736","DOI":"10.21037\/cdt-22-248","article-title":"Management of the left subclavian artery during aortic arch replacement using a\n                    frozen elephant trunk approach: a review","volume":"13","author":"V Orozco-Sevilla","year":"2023","journal-title":"Cardiovasc Diagn Ther"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","DOI":"10.1093\/icvts\/ivac270","article-title":"Cerebral protection in aortic arch surgery: systematic review and\n                    meta-analysis","volume":"35","author":"V Patel","year":"2022","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.athoracsur.2015.03.095","article-title":"Hemiarch and total arch surgery in patients with previous repair of acute type I\n                    aortic dissection","volume":"100","author":"O Preventza","year":"2015","journal-title":"Ann Thorac Surg"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1093\/ejcts\/ezt615","article-title":"How should aortic arch aneurysms be treated in the endovascular aortic repair\n                    era? A risk-adjusted comparison between open and hybrid arch repair using\n                    propensity score-matching analysis","volume":"46","author":"Y Iba","year":"2014","journal-title":"Eur J Cardiothorac Surg"},{"key":"ref14","doi-asserted-by":"crossref","DOI":"10.1002\/9781118548387","volume-title":"Applied Logistic Regression","author":"D W Hosmer Jr","year":"2013"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.jtcvs.2015.08.117","article-title":"Total aortic arch replacement: a comparative study of zone 0 hybrid arch\n                    exclusion versus traditional open repair","volume":"150","author":"O Preventza","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1055\/s-0041-1724003","article-title":"National outcomes of elective hybrid arch debranching with endograft exclusion\n                    versus total arch replacement procedures: analysis of the Society of Thoracic\n                    Surgeons Adult Cardiac Surgery Database","volume":"9","author":"T Wallen","year":"2021","journal-title":"Aorta (Stamford)"}],"container-title":["AORTA"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2965-6246.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:07:14Z","timestamp":1791932834000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2965-6246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":16,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2026,3,26]]},"published-print":{"date-parts":[[2026]]}},"alternative-id":["a29656246"],"URL":"https:\/\/doi.org\/10.1055\/a-2965-6246","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2325-4637"],"issn-type":[{"value":"2325-4637","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]}}}