{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:13:39Z","timestamp":1789665219434,"version":"4.0.1"},"reference-count":28,"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":[[2026,5,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Rates of type B dissection are nearly double those of type A in Marfan syndrome. However, data surrounding clinical and surgical outcomes of type B dissection and associated life expectancy are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We investigated outcomes and survival of type B dissection in a large, single\u2010center Marfan syndrome registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Fifty of 362 (13.8%) patients experienced a type B dissection, with a median postdissection follow\u2010up of 8.9 (interquartile range, 3.9\u201315.4; range, 0\u201333.4) years. Although dissection rates were comparable in men and women (14.4% versus 13.4%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.78), dissection occurred at an earlier age in men (36 versus 46\u2009years,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.025). Seventeen (34.0%) patients required early (&lt;3 months) open thoracoabdominal repair, 17 (34.0%) had late surgery, 14 (28.0%) were managed medically, and 2 (4.0%) suffered rupture with death. Life expectancy was shorter in those with versus without type B dissection (median survival, 71.1 versus 78.5\u2009years, respectively;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.02), but only in men due to earlier age at type B dissection (median age, 60.4 versus 71.1\u2009years;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.004) with comparable postdissection life expectancy. Postdissection survival did not differ on the basis of timing of surgery or medical management. Eleven patients (5.9% of those with prior root replacement) suffered a distal anastomosis dissection at a median of 18.0 (interquartile range, 12.1\u201323.1) years postoperatively, of whom 9 required surgery after a median of 0.59 months (interquartile range, 0.13\u201312.3).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Type B dissection in Marfan syndrome is associated with a shortened life expectancy, but only in men, and usually requires surgical intervention. Distal anastomosis dissection is an underappreciated, important complication after proximal aortic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048274","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T09:39:41Z","timestamp":1776850781000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of Type B Dissection in Marfan Syndrome: The Cornell Aortic Aneurysm Registry"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8999-7278","authenticated-orcid":false,"given":"Nupoor","family":"Narula","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8542-4982","authenticated-orcid":false,"given":"Richard B.","family":"Devereux","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8099-8979","authenticated-orcid":false,"given":"Xiaoyue","family":"Ma","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Trinder","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1407-1443","authenticated-orcid":false,"given":"Leonard","family":"Girardi","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan W.","family":"Weinsaft","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-6769","authenticated-orcid":false,"given":"Mary J.","family":"Roman","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, 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