{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:05:09Z","timestamp":1782734709235,"version":"3.54.5"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,10,22]],"date-time":"2022-10-22T00:00:00Z","timestamp":1666396800000},"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":[[2022,11,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Retrograde type A aortic dissection (RTAAD) can be spontaneous or secondary to the instrumentation of the descending and thoraco-abdominal aorta. It has anatomical differences compared to antegrade type A aortic dissection that impact the management and prognosis. Treatment is not standardized. We report our approach to spontaneous RTAAD in our institution between 2018 and 2022 (n\u2009=\u200915). The mean age was 60.1\u2009years and 93% were male. Aortic valve, coronary arteries and supra-aortic trunks were spared by the dissection in 80% of the cases; distal extension to iliacs was common and lower limb malperfusion was present in 4 cases (27%). The ascending aorta was dilated at presentation in 60% of the cases. Emergency surgery with arch\/FET replacement was offered to 11 patients (73%); 3 patients (20%) received a limited proximal aortic repair; 1 patient was treated conservatively. Overall mortality was 47% (100% for limited proximal repair and 22% for those who received arch\/FET). We advocate for aggressive treatment of RTAAD excluding the primary entry tear to prevent immediate- and mid-term complications.<\/jats:p>","DOI":"10.1093\/icvts\/ivac264","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T15:24:12Z","timestamp":1666365852000},"source":"Crossref","is-referenced-by-count":12,"title":["Retrograde type A aortic dissection: a different evil"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9330-3948","authenticated-orcid":false,"given":"Ana","family":"Lopez-Marco","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, St Bartholomew\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, St Bartholomew\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung Ye","family":"Oo","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, St Bartholomew\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,22]]},"reference":[{"key":"2022110822024299400_ivac264-B1","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":"2022110822024299400_ivac264-B2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/ejcts\/ezz145","article-title":"Standards of reporting in open and endovascular aortic surgery (STORAGE guidelines)","volume":"56","author":"Rylski","year":"2019","journal-title":"Eur J Cardiothorac 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