{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T19:56:15Z","timestamp":1775332575402,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"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":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to compare operative outcomes between patients undergoing thoraco-abdominal aortic aneurysm (TAAA) repair for degenerative disease and chronic dissected aneurysm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on consecutive patients who underwent elective TAAA repair for chronic dissection or degenerative disease between 1997 and 2025. The primary outcome measure was operative mortality, while secondary outcomes included major adverse events (MAE). Factors associated with mortality or MAE were identified using multivariable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 734 patients underwent open TAAA repair, with 339 (46%) having atherosclerotic disease and 395 (54%) having chronic dissection. The degenerative disease group was characterized by older age (71.2\u2009\u00b1\u200910.2vs.58.9\u2009\u00b1\u200913.7, P\u2009&amp;lt;\u2009.001), higher comorbidity burden (such as ischaemic heart disease, pulmonary disease, diabetes, and renal impairment), and lower rates of connective tissue disorders (2.4%vs 26.1%, P\u2009&amp;lt;\u2009.001), and Extent I or II TAAA (57.5% vs 84.3%, P\u2009&amp;lt;\u2009.001). The overall operative mortality rate for the entire cohort was 5.9% and was higher in the chronic dissection group [OR, 2.54 (1.15-5.69), P\u2009=\u2009.022]. Incidence of paraplegia (either immediate or delayed) was higher in the degenerative group (2.8% vs. 0.8%, P\u2009=\u2009.028). Both groups had a similar risk of MAE [OR, 1.49 (0.90-2.45), P\u2009=\u2009.119]. Factors that were associated with MAE included older age [OR, 1.02 (1.00-1.04), P\u2009=\u2009.050], preoperative renal impairment [OR, 1.83 (1.17-2.85), P\u2009=\u2009.007], Extent I or II TAAA [OR, 1.76 (1.17-2.65), P\u2009=\u2009.007], and lower preoperative FEV1 [OR, 0.97 (0.95-0.99), P\u2009=\u2009.001].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic dissection aetiology was associated with higher adjusted operative mortality following open TAAA repair, likely reflecting greater anatomical complexity, with similar risk of MAE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag138","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:43:55Z","timestamp":1774615435000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Risk Profile and Treatment Outcomes in Patients with Thoracoabdominal Aortic Aneurysm: Chronic Dissection Versus Degenerative Disease"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3292-821X","authenticated-orcid":false,"given":"Eilon","family":"Ram","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY 10065,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1862-7827","authenticated-orcid":false,"given":"Christopher","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY 10065,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Gregg","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY 10065,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles Anthony","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY 10065,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Giovanni","family":"Soletti","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY 10065,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4680-0815","authenticated-orcid":false,"given":"Mario","family":"Gaudino","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY 10065,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard N","family":"Girardi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY 10065,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,28]]},"reference":[{"key":"2026040415165020000_ezag138-B1","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.jtcvs.2015.12.050","article-title":"Outcomes of 3309 thoracoabdominal aortic aneurysm repairs","volume":"151","author":"Coselli","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B2","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1016\/j.athoracsur.2020.04.069","article-title":"Open repair of descending thoracic and thoracoabdominal aortic aneurysms: a meta-analysis","volume":"110","author":"Khan","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2026040415165020000_ezag138-B3","article-title":"Long-term clinical outcomes of 1020 open repairs of descending thoracic and thoracoabdominal aortic aneurysms","author":"Lau","year":"2025","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B4","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1016\/j.jtcvs.2018.05.081","article-title":"Open surgical thoracoabdominal aortic aneurysm repair: the Heidelberg experience","volume":"156","author":"Mkalaluh","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B5","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1016\/j.jtcvs.2023.03.029","article-title":"Risk profile and operative outcomes in Marfan Syndrome versus non-Marfan patients undergoing thoracoabdominal aortic aneurysm repair","volume":"166","author":"Lau","year":"2023","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B6","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1161\/CIR.0000000000001106","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":"146","author":"Isselbacher","year":"2022","journal-title":"Circulation"},{"key":"2026040415165020000_ezag138-B7","doi-asserted-by":"crossref","DOI":"10.1093\/ejcts\/ezad426","article-title":"EACTS\/STS guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ","volume":"65","author":"Czerny","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026040415165020000_ezag138-B8","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1016\/j.jtcvs.2016.10.055","article-title":"Impact of preoperative pulmonary function on outcomes after open repair of descending and thoracoabdominal aortic aneurysms","volume":"153","author":"Girardi","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B9","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.athoracsur.2016.10.056","article-title":"Surgical outcomes of chronic descending dissections: type I versus III DeBakey","volume":"104","author":"Gambardella","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2026040415165020000_ezag138-B10","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1016\/j.athoracsur.2018.11.021","article-title":"Open thoracoabdominal aortic aneurysm repair: contemporary outcomes for 393 elective cases","volume":"107","author":"Shimamura","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2026040415165020000_ezag138-B11","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.jvs.2020.06.103","article-title":"Perioperative and long-term outcomes after thoracoabdominal aortic aneurysm repair of chronic dissection etiology","volume":"73","author":"Latz","year":"2021","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B12","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/S0003-4975(02)03370-2","article-title":"Morbidity and mortality after extent II thoracoabdominal aortic aneurysm repair","volume":"73","author":"Coselli","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"2026040415165020000_ezag138-B13","doi-asserted-by":"crossref","first-page":"S134","DOI":"10.1016\/j.jtcvs.2014.09.038","article-title":"Contemporary outcomes of open thoracoabdominal aortic aneurysm repair in octogenarians","volume":"149","author":"Aftab","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B14","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.jtcvs.2019.11.009","article-title":"Impact of left ventricular ejection fraction on the outcomes of open repair of descending thoracic and thoracoabdominal aneurysms","volume":"161","author":"Gambardella","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B15","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1093\/ejcts\/ezx007","article-title":"Open repair of descending thoracic and thoracoabdominal aortic aneurysms in patients with preoperative renal failure","volume":"51","author":"Girardi","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026040415165020000_ezag138-B16","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1016\/j.jtcvs.2010.08.054","article-title":"Early and late results of descending thoracic and thoracoabdominal aortic aneurysm open repair with deep hypothermia and circulatory arrest","volume":"140","author":"Fehrenbacher","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B17","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1161\/CIRCULATIONAHA.108.769695","article-title":"Contemporary analysis of descending thoracic and thoracoabdominal aneurysm repair: a comparison of endovascular and open techniques","volume":"118","author":"Greenberg","year":"2008","journal-title":"Circulation"},{"key":"2026040415165020000_ezag138-B18","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/01.sla.0000086664.90571.7a","article-title":"Distal aortic perfusion and cerebrospinal fluid drainage for thoracoabdominal and descending thoracic aortic repair: ten years of organ protection","volume":"238","author":"Safi","year":"2003","journal-title":"Ann Surg"},{"key":"2026040415165020000_ezag138-B19","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.jvs.2015.10.099","article-title":"A propensity-matched comparison for endovascular and open repair of thoracoabdominal aortic aneurysms","volume":"63","author":"Ferrer","year":"2016","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B20","first-page":"275","article-title":"Open repair of aneurysms of the thoracoabdominal aorta","volume":"64","author":"Kazen","year":"2016","journal-title":"Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B21","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1067\/mva.2002.122024","article-title":"Cerebrospinal fluid drainage reduces paraplegia after thoracoabdominal aortic aneurysm repair: results of a randomized clinical trial","volume":"35","author":"Coselli","year":"2002","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B22","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/j.jtcvs.2017.11.072","article-title":"Intercostal artery management in thoracoabdominal aortic surgery: to reattach or not to reattach?","volume":"155","author":"Afifi","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026040415165020000_ezag138-B23","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S0741-5214(98)70292-7","article-title":"Importance of intercostal artery reattachment during thoracoabdominal aortic aneurysm repair","volume":"27","author":"Safi","year":"1998","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B24","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.jvs.2013.02.036","article-title":"Fate of patients with spinal cord ischemia complicating thoracic endovascular aortic repair","volume":"58","author":"DeSart","year":"2013","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B25","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jvs.2012.01.008","article-title":"Endovascular treatment of thoracoabdominal aortic aneurysms","volume":"56","author":"Guillou","year":"2012","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B26","first-page":"267","article-title":"Combined open and endovascular treatment of thoracoabdominal aortic pathologies: a systematic review and meta-analysis","volume":"1","author":"Moulakakis","year":"2012","journal-title":"Ann Cardiothorac Surg"},{"key":"2026040415165020000_ezag138-B27","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/j.jvs.2015.05.036","article-title":"Endovascular treatment of thoracoabdominal aortic aneurysm using physician-modified endografts","volume":"62","author":"Sweet","year":"2015","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B28","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/j.jvs.2021.09.047","article-title":"Complications after thoracic endovascular aortic repair for ruptured thoracic aortic aneurysms remain high compared with elective repair","volume":"75","author":"Patel","year":"2022","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B29","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.jacc.2009.11.047","article-title":"Endovascular aortic repair versus open surgical repair for descending thoracic aortic disease a systematic review and meta-analysis of comparative studies","volume":"55","author":"Cheng","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2026040415165020000_ezag138-B30","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jvs.2017.01.026","article-title":"The impact of endovascular repair on management and outcome of ruptured thoracic aortic aneurysms","volume":"66","author":"Ultee","year":"2017","journal-title":"J Vasc Surg"},{"key":"2026040415165020000_ezag138-B31","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jvs.2020.05.027","article-title":"Increased hospital volume is associated with reduced mortality after thoracoabdominal aortic aneurysm repair","volume":"73","author":"Polanco","year":"2021","journal-title":"J Vasc 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\/ezag138\/67637051\/ezag138.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/68\/4\/ezag138\/67637051\/ezag138.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/68\/4\/ezag138\/67637051\/ezag138.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T19:17:01Z","timestamp":1775330221000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezag138\/8555588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,28]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezag138","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,3,28]]},"article-number":"ezag138"}}