{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:25:57Z","timestamp":1774383957869,"version":"3.50.1"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nonagenarians represent a cohort of patients at high or prohibitive risk in case of complex aortic procedures. A hybrid approach could reduce the surgical risk compared with a conventional surgery when performed at the age of 90.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We reported the case of a 90-year-old man who presented with a progressive aortic arch dilatation due to a persistent type-1A endoleak following previous thoracic endovascular aortic repair due to type-B aortic dissection. The aortic computed tomography scan confirmed a 65 \u00d7 67\u2005mm aortic arch dilatation due to a type-1A endoleak and a transthoracic echocardiogram showed a severe aortic valve stenosis. On full sternotomy and partial cardiopulmonary bypass assistance, the patient underwent transcatheter aortic valve replacement combined with surgical brachiocephalic trunk and left common carotid artery debranching and thoracic endovascular aortic repair of the aortic arch. The postoperative course was uneventful and the patient was discharged home at postoperative day 15.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The described hybrid procedure lessened the prohibitive risks that could have been related to a conventional open aortic arch surgery in nonagenarians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag161","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:49:33Z","timestamp":1773287373000},"source":"Crossref","is-referenced-by-count":0,"title":["Complex hybrid management of severe aortic stenosis and aortic arch disease in a nonagenarian: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0483-7372","authenticated-orcid":false,"given":"Mirko","family":"Muretti","sequence":"first","affiliation":[{"name":"Cardiac Surgery Unit, Cardiocentro Ticino Institute, EOC , Via Tesserete 48, 6900 Lugano ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4357-2821","authenticated-orcid":false,"given":"Maria Antonella","family":"Ruffino","sequence":"additional","affiliation":[{"name":"Radiology Department, Canton of Ticino, Cantonal Hospital Group , Via Tesserete 46, 6900 Lugano ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6513-3985","authenticated-orcid":false,"given":"Giovanni","family":"Pedrazzini","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiocentro Ticino Institute, EOC , Via Tesserete 48, 6900 Lugano ,","place":["Switzerland"]},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana (USI), Campus est, Via la Santa 1 , 6900 Lugano ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3796-1775","authenticated-orcid":false,"given":"Stefanos","family":"Demertzis","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Cardiocentro Ticino Institute, EOC , Via Tesserete 48, 6900 Lugano ,","place":["Switzerland"]},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana (USI), Campus est, Via la Santa 1 , 6900 Lugano ,","place":["Switzerland"]},{"name":"Faculty of Medicine, University of Bern, Murtenstrasse 11 , 3008 Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8303-8404","authenticated-orcid":false,"given":"Enrico","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Cardiocentro Ticino Institute, EOC , Via Tesserete 48, 6900 Lugano ,","place":["Switzerland"]},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana (USI), Campus est, Via la Santa 1 , 6900 Lugano ,","place":["Switzerland"]},{"name":"Faculty of Medicine, University of Zurich (UHZ), K\u00fcnstlergasse 15 , 8001 Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"2026032412525873800_ytag161-B1","doi-asserted-by":"crossref","first-page":"865008","DOI":"10.3389\/fcvm.2022.865008","article-title":"Modern cardiac surgical outcomes in nonagenarians: a multicentre retrospective observational study","volume":"9","author":"Weinberg","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2026032412525873800_ytag161-B2","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.3390\/jcm12062177","article-title":"Cardiac surgery in nonagenarians following the TAVI\/TMVI era: a multicenter 23-year comparative analysis","volume":"12","author":"Nasso","year":"2023","journal-title":"J Clin Med"},{"key":"2026032412525873800_ytag161-B3","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1111\/jocs.16396","article-title":"Outcomes of cardiac surgery in nonagenarians","volume":"37","author":"Elsisy","year":"2022","journal-title":"J Card Surg"},{"key":"2026032412525873800_ytag161-B4","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.jtcvs.2019.07.092","article-title":"Total arch replacement in octogenarians and nonagenarians: a single-center 18-year experience","volume":"160","author":"Ikeno","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026032412525873800_ytag161-B5","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1536\/ihj.22-153","article-title":"Total arch debranching thoracic endovascular aortic repair using femoral artery inflow","volume":"63","author":"Yamamoto","year":"2022","journal-title":"Int Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag161\/67305698\/ytag161.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/3\/ytag161\/67305698\/ytag161.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/3\/ytag161\/67305698\/ytag161.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:53:02Z","timestamp":1774371182000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag161\/8514946"}},"subtitle":[],"editor":[{"given":"Edoardo","family":"Zancanaro","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Eirini","family":"Beneki","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Giorgia","family":"Benzoni","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Marta Liliana","family":"Medina","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Faris","family":"Kad\u00edc","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":5,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag161","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"ytag161"}}