{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T23:45:55Z","timestamp":1782776755575,"version":"3.54.5"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2003,8,1]],"date-time":"2003-08-01T00:00:00Z","timestamp":1059696000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovascular Surgery"],"published-print":{"date-parts":[[2003,8]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> To evaluate long-term effectiveness of strategies for managing the aortic root and distal aorta in type A dissections. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> From 1990 to 1999, 50 patients (32 men, 64.07%; 18 women, 36.0%; mean age 57.4 y \u00b1 11.1) underwent operation for ascending aortic dissection. Surgical strategies included aortic root replacement with a composite graft (21\/50; 42.0%), valve replacement with supracoronary ascending aortic graft (3\/50, 6%), and valve preservation or repair (26\/50; 52.0%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Overall hospital mortality rate was 18.0%. Follow-up was completed for 47 patients (94.0%) and ranged from 1 month to 10.5 years (mean 28.8 months). Actuarial survival for patients discharged from the hospital was 84% at 1 year, 75% at 5 years, and 66% at 10 years. There was no significant difference between the various procedures regarding mortality, neurological complications, long term survival and proximal re-operations. The ascending aorta alone was replaced in 8\/50 patients (16%), ascending and hemiarch in 30\/50 patients (60%) and arch and proximal descending aorta in 12\/50 patients (24%) Hospital mortality (11.5, 20.0 and 16.7% respectively; p &gt; 0.05) and 5- and 10-year survival ( p &gt; 0.05) were not statistically dependent on the extension of the resection distally. Residual distal dissection was not associated with a decrease in late survival. With regard to emergency surgery (36\/50) there was no significant difference in hospital mortality ( p &gt; 0.05) and 5 year survival ( p &gt; 0.05) between those who had undergone coronary angiography (19\/36; 52.8%) on the day of surgery with those who had not (17\/36; 47.2%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> Preservation or repair of the aortic valve can be recommended in the majority of patients with type A dissection. Distal extension of the resection does not increase surgical risk. Residual distal dissection does not decrease late survival. Preoperative coronary angiography may not affect survival in patients undergoing emergency surgery. <\/jats:p><\/jats:sec>","DOI":"10.1177\/096721090301100404","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T13:09:20Z","timestamp":1663074560000},"page":"265-272","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Effectiveness of Operative Procedures for Stanford Type A Aortic Dissections"],"prefix":"10.1177","volume":"11","author":[{"given":"R.","family":"Driever","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Center, University of Witten\/Herdecke, 42217 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Botsios","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Center, University of Witten\/Herdecke, 42217 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Center, University of Witten\/Herdecke, 42217 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Center, University of Witten\/Herdecke, 42217 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. O.","family":"Vetter","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Center, University of Witten\/Herdecke, 42217 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2003,8,1]]},"reference":[{"key":"bibr1-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(72)90070-7"},{"key":"bibr2-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)64656-5"},{"key":"bibr3-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(96)80308-3"},{"key":"bibr4-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)65594-4"},{"key":"bibr5-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38254-6"},{"key":"bibr6-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(97)00803-5"},{"key":"bibr7-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(93)91100-2"},{"key":"bibr8-096721090301100404","first-page":"235","volume":"90","author":"Smith J. A.","year":"1994","journal-title":"Circulation"},{"key":"bibr9-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36415-3"},{"key":"bibr10-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34942-6"},{"key":"bibr11-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34225-4"},{"key":"bibr12-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)01980-9"},{"key":"bibr13-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)02610-2"},{"key":"bibr14-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36585-7"},{"key":"bibr15-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(00)70090-0"},{"key":"bibr16-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34151-0"},{"issue":"25","key":"bibr17-096721090301100404","volume":"3","author":"Heinemann M.","year":"1991","journal-title":"Circulation Suppl"},{"key":"bibr18-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34835-4"},{"key":"bibr19-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.1994.tb00893.x"},{"key":"bibr20-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)90565-7"},{"key":"bibr21-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1080\/21548331.1994.11442988"},{"key":"bibr22-096721090301100404","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00638-5"}],"container-title":["Cardiovascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/096721090301100404","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/096721090301100404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T21:35:40Z","timestamp":1740778540000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/096721090301100404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,8]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2003,8]]}},"alternative-id":["10.1177\/096721090301100404"],"URL":"https:\/\/doi.org\/10.1177\/096721090301100404","relation":{},"ISSN":["0967-2109"],"issn-type":[{"value":"0967-2109","type":"print"}],"subject":[],"published":{"date-parts":[[2003,8]]}}}