{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:33:34Z","timestamp":1777916014371,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Elderly patients are less likely to undergo surgery for an acute type A aortic dissection (ATAAD). This study aims to understand the risks of surgical treatment in patients 75 and older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective study using an institutional database of patients who underwent ATAAD repair from 2007 to 2021. Outcomes were compared between patients &lt;75 and patients\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:mo>\u2265<\/mml:mo>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      75. Logistic regression was performed for operative mortality, and Cox regression was performed for long-term mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 601 patients underwent surgery for ATAAD, 112 (18.6%) of whom were \u226575. Patients \u226575 were significantly more likely to undergo hemiarch replacement (vs total arch replacement) and concomitant CABG. Operative mortality was 16.1% in patients \u226575 versus 10.2% in those &lt;75 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.078). On multivariable logistic regression, age \u226575 was not significantly associated with operative mortality (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.068). Effect of age on long-term mortality was time-dependent: on Cox regression, being 75 or older and within one-year post-discharge was significantly associated with an increased hazard of death (time-dependent HR 4.56; 95% CI, 2.31\u20139.06;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), while age was not associated with an increased hazard of death after the first postoperative year (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.779).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite reduced survival during the first postoperative year among patients 75\u00a0years and older, operative mortality and late survival were similar across each group. By implication, age alone should not be a deterrent to operative intervention in ATAAD patients, even though further investigation is needed to determine opportunities for improving survival during the first postoperative year after ATAAD repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591241313170","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T06:12:08Z","timestamp":1735884728000},"page":"1600-1606","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of acute type A aortic dissection repair in patients under the age of 75 versus 75 and older"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9123-7836","authenticated-orcid":false,"given":"Reyna","family":"Jones","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Yousef","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2263-8318","authenticated-orcid":false,"given":"James A","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA"},{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek","family":"Serna-Gallegos","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA"},{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danial","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathirvel","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"},{"name":"Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rama","family":"Joshi","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"},{"name":"Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Gelzinis","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"},{"name":"Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Phillippi","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pyongsoo","family":"Yoon","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA"},{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Bonatti","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA"},{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kaczorowski","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA"},{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of 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