{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T02:17:26Z","timestamp":1775009846365,"version":"3.50.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005633","name":"Finnish Foundation for Cardiovascular Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Juselius Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Extended aortic repair is considered a key issue for the long-term durability of surgery for DeBakey type 1 aortic dissection. The risk of aortic degeneration may be higher in young patients due to their long life expectancy. The early outcome and durability of aortic surgery in these patients were investigated in the present study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The subjects of the present analysis were patients under 60 years old who underwent surgical repair for acute DeBakey type 1 aortic dissection at 18 cardiac surgery centres across Europe between 2005 and 2021. Patients underwent ascending aortic repair or total aortic arch repair using the conventional technique or the frozen elephant trunk technique. The primary outcome was 5-year cumulative incidence of reoperation on the distal aorta.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 915 patients underwent surgical ascending aortic repair and 284 patients underwent surgical total aortic arch repair. The frozen elephant trunk procedure was performed in 128 patients. Among 245 propensity score\u2013matched pairs, total aortic arch repair did not decrease the rate of distal aortic reoperation compared to ascending aortic repair (5-year cumulative incidence, 6.7% versus 6.7%, subdistributional hazard ratio 1.127, 95% c.i. 0.523 to 2.427). Total aortic arch repair increased the incidence of postoperative stroke\/global brain ischaemia (25.7% versus 18.4%, P = 0.050) and dialysis (19.6% versus 12.7%, P = 0.003). Five-year mortality was comparable after ascending aortic repair and total aortic arch repair (22.8% versus 27.3%, P = 0.172).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In patients under 60 years old with DeBakey type 1 aortic dissection, total aortic arch replacement compared with ascending aortic repair did not reduce the incidence of distal aortic operations at 5 years. When feasible, ascending aortic repair for DeBakey type 1 aortic dissection is associated with satisfactory early and mid-term outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>ClinicalTrials.gov Identifier: NCT04831073.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrae047","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T16:24:27Z","timestamp":1716222267000},"source":"Crossref","is-referenced-by-count":2,"title":["Aortic arch surgery for DeBakey type 1 aortic dissection in patients aged 60 years or younger"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-8186","authenticated-orcid":false,"given":"Fausto","family":"Biancari","sequence":"first","affiliation":[{"name":"Department of Medicine, South-Karelia Central Hospital, University of Helsinki , Lappeenranta , Finland"},{"name":"Heart and Lung Center, Helsinki University Hospital, University of Helsinki , Helsinki , Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier Rodriguez","family":"Lega","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, University Hospital Gregorio Mara\u00f1\u00f3n , Madrid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Mariscalco","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Glenfield Hospital , Leicester , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1880-152X","authenticated-orcid":false,"given":"Sven","family":"Peterss","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University , Munich , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8749-2962","authenticated-orcid":false,"given":"Joscha","family":"Buech","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University , Munich , Germany"},{"name":"German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance , Munich , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Fiore","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, H\u00f4pitaux Universitaires Henri Mondor, Assistance Publique-H\u00f4pitaux de Paris , Creteil , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Perrotti","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, University of Franche-Comte , Besancon , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Rukosujew","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Muenster , Muenster , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel G","family":"Pinto","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, University Hospital Gregorio Mara\u00f1\u00f3n , Madrid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till","family":"Demal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg , Hamburg , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-5747","authenticated-orcid":false,"given":"Konrad","family":"Wisniewski","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Muenster , Muenster , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Pol","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady , Prague , Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9996-6133","authenticated-orcid":false,"given":"Giuseppe","family":"Gatti","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-thoracic and Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina , Trieste , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Vendramin","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, University Hospital , Udine , 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Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko","family":"Jormalainen","sequence":"additional","affiliation":[{"name":"Heart and Lung Center, Helsinki University Hospital, University of Helsinki , Helsinki , Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo M","family":"Dell\u2019Aquila","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Muenster , Muenster , Germany"},{"name":"Department of Cardiac Surgery, Martin Luther University Halle-Wittenberg , Halle , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0879-3557","authenticated-orcid":false,"given":"Francesco","family":"Onorati","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School , Verona , 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