{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:58:17Z","timestamp":1760162297333},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T00:00:00Z","timestamp":1712966400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T00:00:00Z","timestamp":1712966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Open arch surgery is technically demanding for the surgeon and surgically and biologically invasive for the patient, requiring a variably long period of hypothermic circulatory arrest.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>Here we present a case of an elderly patient with chronic renal failure and multiple splanchnic artery disease successfully treated for a rupturing pseudoaneurysm of the aortic arch with a technique that we developed for particularly frail patients. The procedure includes: triple supra-aortic vessel perfusion; distal thoracic aorta antegrade perfusion; balloon endo-clamping of the descending aorta; and anastomosis of an off-the-shelf hybrid arch prosthesis in Ishimaru zone 0. These maneuvers allowed to maintain an extracorporeal circulation in the phase of distal anastomosis, instead of a period of circulatory arrest, employing just mild hypothermia: technical details are depicted and discussed also in comparison with other methods proposed in the literature.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Being able to take advantage of both open surgery advancements and endovascular methods is the key to cardiovascular surgery success today in front of complex pathologies of the aorta: increasing safety and reducing invasiveness of therapeutic options may progressively extend surgical candidacy to the frailest patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-02671-5","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T05:02:00Z","timestamp":1712984520000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Open aortic arch repair without circulatory arrest by frozen elephant trunk in Ishimaru zone 0"],"prefix":"10.1186","volume":"19","author":[{"given":"Ciro","family":"Bancone","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Della Corte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Lo Presti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasul","family":"Ashurov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Sica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucrezia","family":"Palmieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Di Fraia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa","family":"De Feo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,13]]},"reference":[{"key":"2671_CR1","doi-asserted-by":"publisher","first-page":"3337","DOI":"10.1111\/jocs.15700","volume":"36","author":"M Mousavizadeh","year":"2021","unstructured":"Mousavizadeh M, Daliri M, Aljadayel HA, Mohammed I, Rezaei Y, Bashir M, et al. Hypothermic circulatory arrest time affects neurological outcomes of frozen elephant trunk for acute type a aortic dissection: a systematic review and meta-analysis. J Card Surg. 2021;36:3337\u201351.","journal-title":"J Card Surg"},{"key":"2671_CR2","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1093\/ejcts\/ezab295","volume":"61","author":"K Tsagakis","year":"2022","unstructured":"Tsagakis K, Osswald A, Weymann A, Demircioglu A, Schmack B, Wendt D, et al. The frozen elephant trunk technique: impact of proximalization and four sites perfusion technique. Eur J Cardiothorac Surg. 2022;61:195\u2013203.","journal-title":"Eur J Cardiothorac Surg"},{"key":"2671_CR3","doi-asserted-by":"publisher","first-page":"262","DOI":"10.21037\/cdt-22-73","volume":"12","author":"PG Malvindi","year":"2022","unstructured":"Malvindi PG, Alfonsi J, Berretta P, Cefarelli M, Gatta E, Di Eusanio M. Normothermic frozen elephant thrunk: our experience and literature review. Cardiovasc Diagnosis Therapy. 2022;12:262\u201371.","journal-title":"Cardiovasc Diagnosis Therapy"},{"key":"2671_CR4","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3390\/medicina58030372","volume":"58","author":"A D\u2019Onofrio","year":"2022","unstructured":"D\u2019Onofrio A, Caraffa R, Cibin G, Antonello M, Gerosa G. Total endovascular aortic arch repair: from dream to reality. Medicina. 2022;58:372.","journal-title":"Medicina"},{"key":"2671_CR5","doi-asserted-by":"publisher","first-page":"748","DOI":"10.21037\/acs.2018.10.09","volume":"7","author":"PG Malvindi","year":"2018","unstructured":"Malvindi PG, Magari V, Mastro F, Visicchio G, Kounakis G, Favale A, et al. External aortic cross-clamping and edoaortic balloon occlusion in minimally invasive mitral valve surgery. 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J Card Surg. 2022;37:107\u201311.","journal-title":"J Card Surg"},{"key":"2671_CR8","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1016\/j.athoracsur.2005.11.062","volume":"81","author":"A Della Corte","year":"2006","unstructured":"Della Corte A, Scardone M, Romano G, Amarelli C, Biondi A, De Santo LS, et al. Aortic arch surgery: thoracoabdominal perfusion during antegrade cerebral perfusion may reduce postoperative morbidity. Ann Thorac Surg. 2006;81:1358\u201364.","journal-title":"Ann Thorac Surg"},{"key":"2671_CR9","doi-asserted-by":"publisher","first-page":"S76","DOI":"10.1016\/j.jtcvs.2014.07.100","volume":"149","author":"G Matalanis","year":"2015","unstructured":"Matalanis G, Perera NK, Galvin SD. Aortic arch replacement without circulatory arrest or deep hypothermia: the branch-first technique. 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J Card Surg. 2021;36:3371\u20133.","journal-title":"J Card Surg"},{"key":"2671_CR12","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1007\/s11748-020-01399-y","volume":"68","author":"H Ise","year":"2020","unstructured":"Ise H, Kitahara H, Oyama K, Takahashi K, Kanda H, Fujii S, et al. Hypothermic circulatory arrest induced coagulopathy: rotational thromboelastometry analysis. Gen Thorac Cardiovasc Surg. 2020;68:754\u201361.","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2671_CR13","doi-asserted-by":"publisher","first-page":"516","DOI":"10.21037\/cdt-22-191","volume":"12","author":"P Chivasso","year":"2022","unstructured":"Chivasso P, Masiello P, Miele M, Bruno VD, Genovino AC, Iesu I, et al. The need for custom made frozen elephant trunk: when and where. Cardiovasc Diagnosis Therapy. 2022;12:516\u201320.","journal-title":"Cardiovasc Diagnosis Therapy"},{"key":"2671_CR14","doi-asserted-by":"publisher","first-page":"e000075","DOI":"10.1161\/HCI.0000000000000075","volume":"15","author":"D Fleischmann","year":"2022","unstructured":"Fleischmann D, Aifi AI, Elefteriades JA, Gleason TG, Hanneman K, Roselli EE, et al. Imaging and surveillance of chronic aortic dissection: a scientific statement from the American Heart Association. 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