{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:58:31Z","timestamp":1788562711787,"version":"build-2803163510"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"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":[[2024,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Acute type A aortic dissection (ATAAD) remains a highly life-threatening condition. This study investigates factors associated with fatal ATAAD prior to surgical treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We reviewed autopsy reports of ATAAD decedents who died before surgical intervention and underwent postmortem examination at our clinic from 1994 to 2022.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Among 94 eligible cases, 50 (53.2%) decedents had DeBakey type I dissection, and 44 (46.8%) had DeBakey type II dissection. Most were males, 63 (67%), and 72 (77%) had a history of hypertension. The median age was 70.5\u2009years, and the type II group was a decade older than the type I group (P\u2009&amp;lt;\u20090.001). Decedents in the type II group predominantly died during the first hour after symptoms onset 16 (52%), while in the type I group, fatalities occurred between 1\u2009h and 1\u2009day, 27 (66%). The most common site of the intimal tear was the midportion of the ascending aorta, 45 (48%). The median ascending aorta size was 5\u2009cm for the entire cohort, 5.2\u2009cm for type I and 4.6\u2009cm for type II (P\u2009&amp;lt;\u20090.045).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In this autopsy study of fatal acute aortic dissection, the median aortic size was below the current guideline threshold for elective repair. Type II acute aortic dissections were found more frequently than expected and were characterized by older age, advanced aortic atherosclerosis, smaller aortic size, a shorter interval from symptom onset to death and a higher frequency of syncope compared to type I dissection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad432","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T17:59:26Z","timestamp":1704391166000},"source":"Crossref","is-referenced-by-count":4,"title":["Post-mortem examination of fatal acute type A aortic dissection: what does it teach us?"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0958-7835","authenticated-orcid":false,"given":"Anastasiia","family":"Karadzha","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0994-027X","authenticated-orcid":false,"given":"Hartzell V","family":"Schaff","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L","family":"Frye","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-3744","authenticated-orcid":false,"given":"Melanie C","family":"Bois","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN, USA"},{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A","family":"Crestanello","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Bagameri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L","family":"Greason","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malakh L","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"2024011010231640700_ezad432-B1","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.jacc.2015.05.029","article-title":"Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the International Registry of Acute Aortic Dissection","volume":"66","author":"Pape","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2024011010231640700_ezad432-B2","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1093\/ejcts\/ezw235","article-title":"The incidence and mortality of acute thoracic aortic dissection: results from a whole nation study","volume":"50","author":"Melvinsdottir","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024011010231640700_ezad432-B3","doi-asserted-by":"crossref","first-page":"3802","DOI":"10.1161\/CIRCULATIONAHA.105.534198","article-title":"Acute aortic syndromes","volume":"112","author":"Tsai","year":"2005","journal-title":"Circulation"},{"key":"2024011010231640700_ezad432-B4","doi-asserted-by":"crossref","first-page":"e223","DOI":"10.1016\/j.jacc.2022.08.004","article-title":"2022 ACC\/AHA guideline for the diagnosis and management of Aortic Disease: a report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"80","author":"Isselbacher","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2024011010231640700_ezad432-B5","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.jtcvs.2021.04.053","article-title":"2021 The American Association for Thoracic Surgery expert consensus document: surgical treatment of acute type A aortic dissection","volume":"162","author":"Malaisrie","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024011010231640700_ezad432-B6","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1001\/jama.2016.10026","article-title":"Acute aortic dissection and intramural hematoma: a systematic review","volume":"316","author":"Mussa","year":"2016","journal-title":"JAMA"},{"key":"2024011010231640700_ezad432-B7","doi-asserted-by":"crossref","first-page":"176","DOI":"10.4065\/79.2.176","article-title":"Acute aortic dissection: population-based incidence compared with degenerative aortic aneurysm rupture","volume":"79","author":"Clouse","year":"2004","journal-title":"Mayo Clin Proc"},{"key":"2024011010231640700_ezad432-B8","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.amjcard.2018.04.042","article-title":"Comparison of outcomes in DeBakey type AI versus AII aortic dissection","volume":"122","author":"Kohl","year":"2018","journal-title":"Am J Cardiol"},{"key":"2024011010231640700_ezad432-B9","doi-asserted-by":"crossref","DOI":"10.1093\/ejcts\/ezad175","article-title":"The correlation of age and extension length in DeBakey type I aortic dissection: are older patients over 70 years at a lower risk?","volume":"63","author":"Merkle-Storms","year":"2023","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024011010231640700_ezad432-B10","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)","volume":"35","author":"Erbel","year":"2014","journal-title":"Eur Heart J"},{"key":"2024011010231640700_ezad432-B11","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1161\/CIRCULATIONAHA.107.702720","article-title":"Aortic diameter &gt; or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD)","volume":"116","author":"Pape","year":"2007","journal-title":"Circulation"},{"key":"2024011010231640700_ezad432-B12","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1001\/jamacardio.2022.3305","article-title":"Association of thoracic aortic aneurysm size with long-term patient outcomes: the KP-TAA study","volume":"7","author":"Solomon","year":"2022","journal-title":"JAMA Cardiol"},{"key":"2024011010231640700_ezad432-B13","doi-asserted-by":"crossref","first-page":"6769","DOI":"10.21037\/jtd-21-809","article-title":"Comparison of outcomes in DeBakey type I versus DeBakey type II aortic dissection: a 17-year single center experience","volume":"13","author":"Salehi Ravesh","year":"2021","journal-title":"J Thorac Dis"}],"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\/ezad432\/55024520\/ezad432.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/65\/1\/ezad432\/55265704\/ezad432.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/65\/1\/ezad432\/55265704\/ezad432.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T10:23:25Z","timestamp":1704882205000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezad432\/7510847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezad432","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1,1]]},"published":{"date-parts":[[2024,1,1]]},"article-number":"ezad432"}}