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We report a case of acute type A aortic dissection where postoperative graft kinking led to acute liver failure, kidney injury and lower limb ischaemia corrected by thoracic endovascular aortic repair.<\/jats:p>","DOI":"10.1093\/icvts\/ivaf052","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T22:58:41Z","timestamp":1741129121000},"source":"Crossref","is-referenced-by-count":0,"title":["Delayed visceral malperfusion caused by kinking of a four-branched integrated frozen elephant trunk graft"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8134-7346","authenticated-orcid":false,"given":"Takuya","family":"Matsushiro","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, National Center for Global Health and Medicine , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoki","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, National Center for Global Health and Medicine , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuyuki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, National Center for Global Health and Medicine , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0552-2727","authenticated-orcid":false,"given":"Tadashi","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kitasato University School of Medicine , Sagamihara,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"key":"2025030919563223500_ivaf052-B1","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1053\/j.optechstcvs.2021.12.004","article-title":"Total aortic arch replacements with a 4 branched frozen elephant trunk (FET) graft in acute aortic dissection (DeBakey type 1)","volume":"27","author":"Shrestha","year":"2022","journal-title":"Operative Technique Thorac Cardiovasc Surg"},{"key":"2025030919563223500_ivaf052-B2","doi-asserted-by":"crossref","first-page":"545","DOI":"10.21037\/cdt-22-28","article-title":"Kinking of frozen elephant trunk: reality versus myth\u2014a case report and literature reported","volume":"12","author":"Okita","year":"2022","journal-title":"Cardiovasc Diagn Ther"},{"key":"2025030919563223500_ivaf052-B3","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s11748-023-01997-6","article-title":"Thoracic and cardiovascular surgeries in Japan during 2021: annual report by the Japanese Association for Thoracic Surgery","volume":"72","author":"Yoshimura","year":"2024","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2025030919563223500_ivaf052-B4","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1093\/icvts\/ivx387","article-title":"Kinking of an open stent graft after total arch replacement with the frozen elephant technique for acute Type A aortic dissection","volume":"26","author":"Morisaki","year":"2018","journal-title":"Interact Cardiovasc Thorac Surg"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivaf052\/62210161\/ivaf052.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/3\/ivaf052\/62210161\/ivaf052.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/3\/ivaf052\/62210161\/ivaf052.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T19:56:44Z","timestamp":1741550204000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivaf052\/8046660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":4,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3,5]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivaf052","relation":{},"ISSN":["2753-670X"],"issn-type":[{"type":"electronic","value":"2753-670X"}],"subject":[],"published-other":{"date-parts":[[2025,3]]},"published":{"date-parts":[[2025,3,1]]},"article-number":"ivaf052"}}