{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:20:30Z","timestamp":1783117230131,"version":"3.54.6"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T00:00:00Z","timestamp":1698192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Acute aortic syndromes are associated with poor outcomes, despite diagnostic and therapeutic advances. We analysed trends in volumes and outcomes from 2000 to 2021.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>The study population includes 494 type A acute aortic syndromes (TAAAS) (54.2%) and 418 type B acute aortic syndromes (TBAAS) (45.8%). Primary outcomes were in-hospital mortality, long-term survival and freedom from aortic reoperation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Regardless the type of acute aortic syndrome, patient volumes increased over time. Patients with TBAAS were older, more likely to have comorbid conditions and previous cardiac surgery (P\u2009&amp;lt;\u20090.001), while cerebrovascular accidents were more frequent in TAAAS (P\u2009&amp;lt;\u20090.05). Among TAAAS, 143 (28.9%) required total arch and 351 (71.1%) hemiarch replacement. TBAAS management was medical therapy in 182 (43.5%), endovascular in 198 (47.4%) and surgical in 38 (9.1%) cases. Overall in-hospital mortality was 14.6% [18.2% in TAAAS (95% confidence interval (CI) 14.4\u201321.2%) vs 10.7% in TBAAS (95% CI 7.8%\u201313.7%); P\u2009=\u20090.0027]. After propensity score adjustment, in-hospital mortality exhibited a significantly decreasing trend from 2000 to 2021 (P\u2009&amp;lt;\u20090.001) in TAAAS and TBAAS. 1-, 5- and 10-year survival was 74.2%, 62.2% and 45.5% in TAAAS and 75.4%, 60.7% and 41.0% in TBAAS (P\u2009=\u20090.975), with no differences among treatment strategies. The adjusted cumulative reoperation risk at 10\u2009years was more than two-fold in TBAAS versus TAAAS (9.5% vs 20.5%, hazard ratio (HR)\u2009=\u20092.30, 95% I 1.31\u20134.04).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In the last decades, better patient triage and surgical\/endovascular techniques led to substantial improvements in the management of acute aortic syndrome, with reduction in early mortality and reoperation rate. However, long-term mortality is still &amp;gt;50%.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad350","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T19:02:57Z","timestamp":1698260577000},"source":"Crossref","is-referenced-by-count":8,"title":["Survival and reoperation in acute aortic syndromes\u2014a single-centre experience of 912 patients"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-2024","authenticated-orcid":false,"given":"Giacomo","family":"Murana","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department, IRCCS, Azienda Ospedaliero-Universitaria di Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0111-7123","authenticated-orcid":false,"given":"Gregorio","family":"Gliozzi","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department, IRCCS, Azienda Ospedaliero-Universitaria di Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7704-0831","authenticated-orcid":false,"given":"Paola","family":"Rucci","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences, University of Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Votano","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department, IRCCS, Azienda Ospedaliero-Universitaria di Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Orioli","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department, IRCCS, Azienda Ospedaliero-Universitaria di Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Rosa","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences, University of Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Folesani","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiac Surgery Department, IRCCS, Azienda Ospedaliero-Universitaria di Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Buia","sequence":"additional","affiliation":[{"name":"Cardiovascular Radiology Unit, Cardio-Thoraco-Vascular Department, IRCCS, Azienda Ospedaliero-Universitaria di Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Lovato","sequence":"additional","affiliation":[{"name":"Cardiovascular Radiology Unit, Cardio-Thoraco-Vascular Department, IRCCS, Azienda 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