{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T01:51:43Z","timestamp":1788573103585,"version":"build-2803163510"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":189,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aorta (Stamford)"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The aim of the study was to assess the indications, surgical strategies, and outcomes after reoperative aortic arch surgery performed generally under mild hypothermia.<\/jats:p><jats:p>\n          Methods\u2003Ninety consecutive patients (60 males, mean age, 55\u2009\u00b1\u200916 years) underwent open reoperative aortic arch surgery after previous cardiac aortic surgery. The indications included chronic-progressive arch aneurysm (55.5%), chronic aortic dissection (17.8%), contained arch rupture (16.7%), and graft infection (10%). The reoperation was performed through a repeat sternotomy (96%) or clamshell thoracotomy (4%) using antegrade cerebral perfusion under mild systemic hypothermia (28.9\u2009\u00b1\u20092.5\u00b0C) in all except three patients.<\/jats:p><jats:p>\n          Results\u2003The surgery comprised hemiarch or total arch replacement in 41 (46%) and 49 (54%) patients, respectively. The distal extension included classic or frozen elephant trunk technique, each in 12 patients, and total descending aorta replacement in 4 patients. Operative mortality was 6 (6.7%) among all patients, with age identified as the only independent predictor of operative mortality (p\u2009=\u20090.05). Permanent and transient neurologic deficits occurred in 1% and 9% of the patients, respectively. Estimated survival at 8 years was 59\u2009\u00b1\u20098% with advanced heart failure predictive for late mortality (p\u2009=\u20090.014). Freedom from second reoperation or intervention on the aorta was 78\u2009\u00b1\u20096% at 8 years, with most of these events occurring downstream in patients with chronic degenerative aneurysms.<\/jats:p><jats:p>\n          Conclusion\u2003Aortic arch reoperations performed using antegrade cerebral perfusion under mild systemic hypothermia offer favorable operative outcomes with an exceptionally low rate of neurologic morbidity without any difference between hemiarch and complex arch procedures.<\/jats:p>","DOI":"10.1055\/s-0041-1725073","type":"journal-article","created":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T21:01:52Z","timestamp":1633813312000},"page":"060-066","source":"Crossref","is-referenced-by-count":10,"title":["Reoperative Aortic Arch Surgery under Mild Systemic Hypothermia: Two-Center Experience"],"prefix":"10.1055","volume":"09","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-5057","authenticated-orcid":false,"given":"Petar","family":"Risteski","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Radacki","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Zierer","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Vascular, and Thoracic Surgery, Kepler University Hospital, Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aris","family":"Lenos","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Moritz","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul P.","family":"Urbanski","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jtcvs.2007.11.071","article-title":"Reoperative aortic root and transverse arch procedures: a comparison with contemporaneous primary operations","volume":"136","author":"C D Etz","year":"2008","journal-title":"J Thorac 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