{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T12:44:06Z","timestamp":1753274646894,"version":"3.37.3"},"reference-count":6,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":84,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aorta (Stamford)"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The initial goal of acute Type A aortic dissection (ATAAD) repair remains to get the patient off the table safely. More extensive repair is being pushed at the index operation with the frozen elephant trunk (FET) operation, but outcomes are suggested to be worse. However, we hypothesize that the risk associated with the FET in ATAAD is from the patient presenting factors rather than the operation itself.<\/jats:p><jats:p>\n          Methods\u2003A retrospective review of a single institution prospective database from 2015 to 2021 was performed. Two cohorts were created based on the indication for FET: evidence of radiographic malperfusion (n\u2009=\u200944) or clinical malperfusion (n\u2009=\u200931). Data were analyzed for preoperative characteristics, intraoperative characteristics, and postoperative outcomes. Statistical univariate analysis was performed with chi-square analysis and t-tests with significance determined at an alpha level of 0.05.<\/jats:p><jats:p>\n          Results\u2003Preoperative characteristics were similar in each group, independent of malperfusion markers. The intraoperative characteristics were similar, except the clinical malperfusion group had more packed red blood cells and cryoprecipitate given. The clinical malperfusion group had longer intensive care unit length of stay (p\u2009&lt;\u20090.001), more postoperative strokes (p\u2009&lt;\u20090.001), more reoperations (p &lt;0.0001), and higher mortality rate (p\u2009=\u20090.0003).<\/jats:p><jats:p>\n          Conclusion\u2003These data suggest that clinical malperfusion increases the risk of major complications and death. However, full arch replacement with FET in the absence of clinical malperfusion does not appear to add risk to the operation for ATAAD. Patients with increased risk of distal degeneration should be considered for more aggressive replacement to avoid subsequent arch replacement.<\/jats:p>","DOI":"10.1055\/s-0043-1768970","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T22:37:07Z","timestamp":1692916627000},"page":"112-115","source":"Crossref","is-referenced-by-count":1,"title":["Frozen Elephant Trunk for Acute Type A Dissection: Is Risk from Procedure or Patient Characteristics?"],"prefix":"10.1055","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0336-6038","authenticated-orcid":false,"given":"R.","family":"Wilson King","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam M.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly C.","family":"Higa","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University, Stanford, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Joseph C.","family":"Cleveland","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Colorado, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica Y.","family":"Rove","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Colorado, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Aftab","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Colorado, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Brett Reece","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Colorado, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jtcvs.2019.10.031","article-title":"Neurologic complications after the frozen elephant trunk procedure: a meta-analysis of more than 3000 patients","volume":"160","author":"O Preventza","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.jtcvs.2005.09.050","article-title":"Extensive deployment of the stented elephant trunk is associated with an increased risk of spinal cord injury","volume":"131","author":"J Flores","year":"2006","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"164","DOI":"10.21037\/acs-2020-fet-60","article-title":"Frozen elephant trunk with straight vascular prosthesis","volume":"9","author":"H Jakob","year":"2020","journal-title":"Ann Cardiothorac Surg"},{"issue":"02","key":"ref4","first-page":"329","article-title":"Long-term experience with the E-vita open hybrid graft in complex thoracic aortic disease","volume":"51","author":"H Jakob","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1093\/ejcts\/ezu173","article-title":"The frozen elephant trunk technique for acute type A aortic dissection: results from 15 years of experience","volume":"47","author":"A Katayama","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.jtcvs.2019.03.121","article-title":"Total aortic arch replacement with frozen elephant trunk technique: results from two European institutes","volume":"159","author":"A Leone","year":"2020","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["AORTA"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1768970.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T22:37:27Z","timestamp":1692916647000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1768970"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":6,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,8,24]]},"published-print":{"date-parts":[[2023,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1768970","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2325-4637"],"issn-type":[{"type":"electronic","value":"2325-4637"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}