{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:33:11Z","timestamp":1760189591481,"version":"3.41.2"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,9,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Thoracic endovascular aortic repair is characterized by a substantial need for reintervention. Secondary open aortic procedure becomes necessary when further endoluminal options are exhausted. This synopsis and quantitative analysis of available evidence aims to overcome the limitations of institutional cohort reports on secondary open aortic procedure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Electronic databases were searched from 1994 to the present date with a prospectively registered protocol. Pooled quantification of pre\/intraoperative variables, and proportional meta\u2010analysis with random effect model of early and midterm outcomes were performed. Subgroup analysis was conducted for patients who had early mortality. Fifteen studies were elected for final analysis, encompassing 330 patients. The following values are expressed as \u201cpooled mean, 95% confidence interval.\u201d Type B dissection was the most common pathology at index thoracic endovascular aortic repair (51.2%, 44.4\u201357.9). The most frequent indication for secondary open aortic procedure was endoleak (39.7%, 34.6\u201345.1). More than half of patients had surgery on the descending aorta (51.2%, 45.8\u201356.6), and one fourth on the arch (25.2%, 20.8\u201330.1). Operative mortality was 10.6% (7.4\u201314.9). Neurological morbidity was substantial between stroke (5.1%, 2.8\u20139.1) and paraplegia (8.3%, 5.2\u201313.1). At 2\u2010year follow\u2010up, mortality (20.4%, 11.5\u201333.5) and aortic adverse event (aortic death 7.7%, 4.3\u201313.3, tertiary aortic open procedure 7.4%, 4.0\u201313.2) were not negligible.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In the secondary open aortic procedure population, type B dissection was both the most common pathology and the one associated with the lowest early mortality, whereas aortic infection and extra\u2010anatomical bypass were associated with the most ominous prognosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.006618","type":"journal-article","created":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T00:10:58Z","timestamp":1505347858000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Secondary Open Aortic Procedure Following Thoracic Endovascular Aortic Repair: Meta\u2010Analytic State of the Art"],"prefix":"10.1161","volume":"6","author":[{"given":"Ivancarmine","family":"Gambardella","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George A.","family":"Antoniou","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Manchester, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Torella","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Service, Royal Liverpool University Hospital, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiano","family":"Spadaccio","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aung Y.","family":"Oo","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Gaudino","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Nappi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Center, Cardiologique du Nord de Saint\u2010Denis, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Information Department, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard N.","family":"Girardi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"657","article-title":"Successful resection of fusiform aneurysm of aortic arch with replacement by homograft","volume":"105","author":"DeBakey ME","year":"1957","unstructured":"DeBakey ME, Crawford ES, Cooley DA, Morris GC Jr. Successful resection of fusiform aneurysm of aortic arch with replacement by homograft. 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