{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:49:53Z","timestamp":1789264193068,"version":"build-2803163510"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Our goal was to evaluate the surgical and conservative outcomes of acute type A aortic dissection with a thrombosed false lumen of the ascending aorta in elderly patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients older than 75\u2009years with acute type A aortic dissection admitted to our hospital from October 2011 to December 2020 were reviewed retrospectively, including those with the noncommunicating type without malperfusion and low physical capacity prehospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Sixty-six patients were enrolled consecutively in the medical (M, n\u2009=\u200930) and surgical (S, n\u2009=\u200936) groups. The ascending aorta was the most replaced section in the S group (78%). Groups did not differ significantly in hospital deaths and in intensive care unit and hospital stays. Two patients (7%) underwent surgery and 3 (10%) underwent redissection in the M group. No significant difference existed between the groups in the decline of physical performance during hospitalization. Seven patients in the M group (24%) had aorta-related events in the late period as opposed to none in the S group (P=0.003). Survival rates after 4\u2009years were 78.3% and 71.4% in the S and M groups, respectively (P=0.154). The cumulative incidence of overall reintervention due to an aortic event was significantly higher in the M group; however, the 2 groups did not differ significantly in overall aorta-related deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Surgical outcomes of noncommunicating acute type A aortic dissection in elderly patients were favorable. There was no significant difference in maintaining physical function at discharge, and the medical group had a significantly higher overall aortic event rate than the surgical group.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezac484","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T13:46:31Z","timestamp":1665063991000},"source":"Crossref","is-referenced-by-count":12,"title":["Noncommunicating acute type A aortic dissection in elderly patients: Surgery versus medical management"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3848-0153","authenticated-orcid":false,"given":"Kosuke","family":"Nakamae","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8942-0981","authenticated-orcid":false,"given":"Takashi","family":"Oshitomi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6214-1373","authenticated-orcid":false,"given":"Hideyuki","family":"Uesugi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Ideta","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9336-3860","authenticated-orcid":false,"given":"Kentaro","family":"Takaji","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiharu","family":"Sassa","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Murata","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Hirota","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital , Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"2022121406070888200_ezac484-B1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.athoracsur.2017.06.057","article-title":"Early and late surgical outcomes of acute type A aortic dissection in octogenarians","volume":"105","author":"Kawahito","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2022121406070888200_ezac484-B2","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1093\/ejcts\/ezaa080","article-title":"Watch-and-wait strategy for type A intramural haematoma and acute aortic dissection with thrombosed false lumen of the ascending aorta: A Japanese single-centre experience","volume":"58","author":"Kitamura","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022121406070888200_ezac484-B3","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1016\/S0735-1097(01)01184-6","article-title":"Different clinical features of aortic intramural hematoma versus dissection involving the ascending aorta","volume":"37","author":"Song","year":"2001","journal-title":"J Am Coll Cardiol"},{"key":"2022121406070888200_ezac484-B4","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1067\/mtc.2002.121681","article-title":"Midterm follow-up of penetrating ulcer and intramural hematoma of the aorta","volume":"123","author":"Tittle","year":"2002","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022121406070888200_ezac484-B5","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1161\/01.CIR.0000052628.77047.EA","article-title":"Intramural hematoma of the aorta: redictors of progression to dissection and rupture","volume":"107","author":"von Kodolitsch","year":"2003","journal-title":"Circulation"},{"key":"2022121406070888200_ezac484-B6","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1093\/icvts\/ivab320","article-title":"Cardiac surgery in older patients: Hospital outcomes during a 15-year period from a complete national series","volume":"34","author":"Jones","year":"2022","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2022121406070888200_ezac484-B7","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1093\/ejcts\/ezaa195","article-title":"The results of an entry-oriented strategy for acute type A aortic dissection in octogenarians: An 18-year experience","volume":"58","author":"Igarashi","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022121406070888200_ezac484-B8","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.tcm.2021.09.002","article-title":"The role of philosophy of life approaching type A acute aortic dissection","volume":"32","author":"Picich\u00e8","year":"2022","journal-title":"Trends Cardiovasc Med"},{"key":"2022121406070888200_ezac484-B9","doi-asserted-by":"crossref","first-page":"2806","DOI":"10.1016\/j.ijcard.2012.07.008","article-title":"Acute aortic dissection: Epidemiology and outcomes","volume":"167","author":"Pacini","year":"2013","journal-title":"Int J Cardiol"},{"key":"2022121406070888200_ezac484-B10","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.jtcvs.2009.11.014","article-title":"Role of age in acute type A aortic dissection outcome: Report from the International Registry of Acute Aortic Dissection (IRAD)","volume":"140","author":"Trimarchi","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022121406070888200_ezac484-B11","first-page":"435","article-title":"Outcome after surgery for acute aortic dissection type A in patients over 70 years: Data analysis from the German registry for acute aortic dissection type A (GERAADA)","volume":"40","author":"Rylski","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022121406070888200_ezac484-B12","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.ejcts.2010.04.015","article-title":"Preoperative prediction of intensive care unit stay following cardiac surgery","volume":"39","author":"De Cocker","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022121406070888200_ezac484-B13","doi-asserted-by":"crossref","first-page":"e010764","DOI":"10.1136\/bmjopen-2015-010764","article-title":"Factors associated with prolonged length of stay following cardiac surgery in a major referral hospital in Oman: A retrospective observational study","volume":"6","author":"Almashrafi","year":"2016","journal-title":"BMJ Open"},{"key":"2022121406070888200_ezac484-B14","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/BF03654834","article-title":"Determinants of prolonged intensive care unit stay after cardiac surgery in the elderly","volume":"24","author":"Cacciatore","year":"2012","journal-title":"Ageing Clin Exp Res"},{"key":"2022121406070888200_ezac484-B15","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1093\/oxfordjournals.bja.a013444","article-title":"Central nervous system complications of cardiac surgery","volume":"84","author":"Arrowsmith","year":"2000","journal-title":"Br J Anaesth"},{"key":"2022121406070888200_ezac484-B16","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1007\/s00380-020-01583-3","article-title":"A novel risk score on admission for predicting death or need for surgery in patients with acute type A intramural hematoma receiving medical therapy","volume":"35","author":"Kageyama","year":"2020","journal-title":"Heart Vessels"},{"key":"2022121406070888200_ezac484-B17","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.ijcard.2020.03.041","article-title":"Prediction of adverse events in patients with initially medically treated type A intramural hematoma","volume":"313","author":"Li","year":"2020","journal-title":"Int J Cardiol"},{"key":"2022121406070888200_ezac484-B18","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1148\/rg.2016150094","article-title":"Emerging concepts in intramural hematoma imaging","volume":"36","author":"Gutschow","year":"2016","journal-title":"Radiographics"},{"key":"2022121406070888200_ezac484-B19","doi-asserted-by":"crossref","first-page":"203","DOI":"10.2147\/VHRM.S193967","article-title":"Diagnosing aortic intramural hematoma: Current perspectives","volume":"16","author":"Ferrera","year":"2020","journal-title":"Vasc Health Risk Manag"},{"key":"2022121406070888200_ezac484-B20","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jtcvs.2020.03.157","article-title":"Midterm outcomes of emergency surgery for acute type A aortic dissection in octogenarians","volume":"163","author":"Bojko","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022121406070888200_ezac484-B21","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.athoracsur.2018.10.010","article-title":"Emergency surgery for acute Type A aortic dissection in octogenarians without patient selection","volume":"107","author":"Suzuki","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2022121406070888200_ezac484-B22","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.athoracsur.2016.05.046","article-title":"Early and late outcomes of operation for acute type A aortic dissection in patients aged 80 years and older","volume":"103","author":"Omura","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2022121406070888200_ezac484-B23","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.athoracsur.2009.04.096","article-title":"Outcomes after surgical treatment for type A acute aortic dissection in octogenarians: A multicenter study","volume":"88","author":"Piccardo","year":"2009","journal-title":"Ann Thorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezac484\/46352019\/ezac484.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/6\/ezac484\/47846483\/ezac484.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/6\/ezac484\/47846483\/ezac484.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T13:32:32Z","timestamp":1701178352000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezac484\/6749559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,6]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac484","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,12,1]]},"published":{"date-parts":[[2022,10,6]]},"article-number":"ezac484"}}