{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T19:15:14Z","timestamp":1783451714963,"version":"3.55.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Surgery of acute aortic dissection using the frozen elephant trunk (FET) can be complicated when the origin of the left subclavian artery (LSA) is dissected and sacrifice by ligation is a viable option. However, the LSA is supposed to play a role in neuroprotection as a major collateral. We, therefore, analyzed our results of LSA sacrifice in this cohort.<\/jats:p><jats:p>\n          Methods\u2003We identified a total of 84 patients from our prospectively collected database who underwent FET repair of acute aortic dissection between October 2009 and April 2018. LSA was sacrificed in 19 patients (22.6%). Results were analyzed and compared with regard to neurological outcomes.<\/jats:p><jats:p>\n          Results\u2003New postoperative stroke was seen in two patients (2.4%) and spinal cord injury in three patients (3.6%) overall, none in the LSA-sacrifice group. We observed a temporary neurological deficit in five patients (6.0%) overall, none in the LSA-sacrifice group. None of the patients developed acute ischemia of the left arm. Only two patients (12.5%) came back for carotid-subclavian artery bypass due to exertion-induced weakness of the left arm 3 to 4 months after the initial surgery. In-hospital mortality was 15.5% overall, with no difference between groups.<\/jats:p><jats:p>\n          Conclusion\u2003LSA sacrifice was not associated with elevated postoperative risk of either central or spinal neurological injury. Thus, it can facilitate FET repair of acute aortic dissection in selected cases when the left subclavian origin cannot be preserved. Carotid-subclavian artery bypass became necessary in only a small fraction of these patients and can be performed as a second-stage procedure.<\/jats:p>","DOI":"10.1055\/s-0041-1741058","type":"journal-article","created":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T23:49:48Z","timestamp":1642463388000},"page":"623-629","source":"Crossref","is-referenced-by-count":4,"title":["Left Subclavian Artery Sacrifice in Acute Aortic Dissection Repair using the Frozen Elephant Trunk"],"prefix":"10.1055","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7692-3480","authenticated-orcid":false,"given":"Nora","family":"Goebel","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone A.","family":"Holder","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Huether","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothee H. L.","family":"Bail","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich F. W.","family":"Franke","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,1,17]]},"reference":[{"issue":"41","key":"ref1","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult","volume":"35","author":"R Erbel","year":"2014","journal-title":"Eur Heart J"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/ejcts\/ezy313","article-title":"Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and 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