{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:31:23Z","timestamp":1783395083293,"version":"3.54.6"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"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>During the coronavirus disease (COVID-19) pandemic, medical resources have often been limited to emergency surgeries. This study aimed to evaluate our experience with delayed surgery for acute type A aortic dissections (ATAADs).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective study was conducted on 33 patients who underwent surgery for ATAADs between January 2020 and December 2021. The patients were divided into two groups: patients treated within 12\u00a0h of arrival (E group; <jats:italic>N<\/jats:italic>\u2009=\u200921) and those treated\u2009&gt;\u200912\u00a0h after arrival (D group; <jats:italic>N<\/jats:italic>\u2009=\u200912) with strict antihypertensive therapy until surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The plasma fibrinogen levels on arrival were lower in the D group than in the E group (174.3\u2009\u00b1\u2009109.1 vs 293.4\u2009\u00b1\u2009165.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.038). The time to surgery from symptom onset was longer in the D group than in the E group (4\u2009\u00b1\u20091\u00a0h vs. 86\u2009\u00b1\u2009108\u00a0h, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was one case (3%) of mortality and seven cases (21%) of cerebral infarctions in the E group. There was no significant difference in the intraoperative data and quantity of blood transfused between the two groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Thus, delayed surgery for ATAAD with appropriate preoperative management may be an alternative surgical strategy in the COVID-19 era.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-02682-2","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T06:02:08Z","timestamp":1713592928000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Delayed surgery for acute type A aortic dissection: a retrospective review of an alternative surgical strategy in the COVID-19 era"],"prefix":"10.1186","volume":"19","author":[{"given":"Rin","family":"Itokawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Kowatari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Imamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanae","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiro","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Daitoku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Minakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,20]]},"reference":[{"key":"2682_CR1","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s11748-020-01460-w","volume":"69","author":"H Shimizu","year":"2021","unstructured":"Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Shimizu H, Okada M, Toh Y, Doki Y, Endo S, et al. Thoracic and cardiovascular surgeries in Japan during 2018: annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2021;69:179\u2013212. https:\/\/doi.org\/10.1007\/s11748-020-01460-w.","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2682_CR2","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1016\/j.athoracsur.2020.08.002","volume":"111","author":"AA Sabe","year":"2021","unstructured":"Sabe AA, Percy ED, Kaneko T, Plichta RP, Hughes GC. When to consider deferral of surgery in acute type A aortic dissection: a review. Ann Thorac Surg. 2021;111:1754\u201362. https:\/\/doi.org\/10.1016\/j.athoracsur.2020.08.002.","journal-title":"Ann Thorac Surg"},{"key":"2682_CR3","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1016\/j.athoracsur.2020.04.003","volume":"110","author":"JW Haft","year":"2020","unstructured":"Haft JW, Atluri P, Ailawadi G, Engelman DT, Grant MC, Hassan A, et al. Adult cardiac surgery during the COVID-19 pandemic: a tiered patient triage guidance statement. Ann Thorac Surg. 2020;110:697\u2013700. https:\/\/doi.org\/10.1016\/j.athoracsur.2020.04.003.","journal-title":"Ann Thorac Surg"},{"key":"2682_CR4","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1016\/j.jacc.2015.05.029","volume":"66","author":"LA Pape","year":"2015","unstructured":"Pape LA, Awais M, Woznicki EM, Suzuki T, Trimarchi S, Evangelista A, et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the international registry of acute aortic dissection. J Am Coll Cardiol. 2015;66:350\u20138. https:\/\/doi.org\/10.1016\/j.jacc.2015.05.029.","journal-title":"J Am Coll Cardiol"},{"key":"2682_CR5","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.jtcvs.2021.04.053","volume":"162","author":"SC Malaisrie","year":"2021","unstructured":"Malaisrie SC, Szeto WY, Halas M, Girardi LN, Coselli JS, Sundt TM, et al. 2021 The American Association for Thoracic Surgery expert consensus document: surgical treatment of acute type A aortic dissection. J Thorac Cardiovasc Surg. 2021;162:735\u2013758.e2. https:\/\/doi.org\/10.1016\/j.jtcvs.2021.04.053.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2682_CR6","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1001\/jama.283.7.897","volume":"283","author":"PG Hagan","year":"2000","unstructured":"Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897\u2013903. https:\/\/doi.org\/10.1001\/jama.283.7.897.","journal-title":"JAMA"},{"key":"2682_CR7","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/s0022-5223(03)00358-1","volume":"126","author":"I Fukuda","year":"2003","unstructured":"Fukuda I, Imazuru T. Intentional delay of surgery for acute type A dissection with stroke. J Thorac Cardiovasc Surg. 2003;126:290\u20131. https:\/\/doi.org\/10.1016\/s0022-5223(03)00358-1.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2682_CR8","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1016\/s0003-4975(97)01100-4","volume":"64","author":"GM Deeb","year":"1997","unstructured":"Deeb GM, Williams DM, Bolling SF, Quint LE, Monaghan H, Sievers J, et al. Surgical delay for acute type A dissection with malperfusion. Ann Thorac Surg. 1997;64:1669\u201375. https:\/\/doi.org\/10.1016\/s0003-4975(97)01100-4. discussion 1675.","journal-title":"Ann Thorac Surg"},{"key":"2682_CR9","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.jtcvs.2017.08.021","volume":"155","author":"R Hamad","year":"2018","unstructured":"Hamad R, Amr G, Demers P. Delayed surgery in patients with acute type A aortic dissection who are receiving novel oral anticoagulants. J Thorac Cardiovasc Surg. 2018;155:e1\u20134. https:\/\/doi.org\/10.1016\/j.jtcvs.2017.08.021.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2682_CR10","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1016\/j.athoracsur.2011.01.058","volume":"91","author":"D Paparella","year":"2011","unstructured":"Paparella D, Rotunno C, Guida P, Malvindi PG, Scrascia G, De Palo M, et al. Hemostasis alterations in patients with acute aortic dissection. Ann Thorac Surg. 2011;91:1364\u20139. https:\/\/doi.org\/10.1016\/j.athoracsur.2011.01.058.","journal-title":"Ann Thorac Surg"},{"key":"2682_CR11","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004710","volume":"95","author":"X Guan","year":"2016","unstructured":"Guan X, Li J, Gong M, Lan F, Zhang H. The hemostatic disturbance in patients with acute aortic dissection: a prospective observational study. Medicine. 2016;95: e4710. https:\/\/doi.org\/10.1097\/MD.0000000000004710.","journal-title":"Medicine"},{"key":"2682_CR12","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1097\/00000658-200109000-00007","volume":"234","author":"JE Bavaria","year":"2001","unstructured":"Bavaria JE, Pochettino A, Brinster DR, Gorman RC, McGarvey ML, Gorman JH, et al. New paradigms and improved results for the surgical treatment of acute type A dissection. Ann Surg. 2001;234:336\u201342. https:\/\/doi.org\/10.1097\/00000658-200109000-00007. discussion 342.","journal-title":"Ann Surg"},{"key":"2682_CR13","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1016\/j.athoracsur.2010.12.005","volume":"91","author":"L Sun","year":"2011","unstructured":"Sun L, Qi R, Zhu J, Liu Y, Chang Q, Zheng J. Repair of acute type A dissection: our experiences and results. Ann Thorac Surg. 2011;91:1147\u201352. https:\/\/doi.org\/10.1016\/j.athoracsur.2010.12.005.","journal-title":"Ann Thorac Surg"},{"key":"2682_CR14","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.1016\/j.jacc.2013.10.085","volume":"63","author":"ND Andersen","year":"2014","unstructured":"Andersen ND, Ganapathi AM, Hanna JM, Williams JB, Gaca JG, Hughes GC. Outcomes of acute type a dissection repair before and after implementation of a multidisciplinary thoracic aortic surgery program. J Am Coll Cardiol. 2014;63:1796\u2013803. https:\/\/doi.org\/10.1016\/j.jacc.2013.10.085.","journal-title":"J Am Coll Cardiol"},{"key":"2682_CR15","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1213\/ANE.0000000000004844","volume":"131","author":"A Shander","year":"2020","unstructured":"Shander A, Goobie SM, Warner MA, Aapro M, Bisbe E, Perez-Calatayud AA, et al. Essential role of patient blood management in a pandemic: a call for action. Anesth Analg. 2020;131:74\u201385. https:\/\/doi.org\/10.1213\/ANE.0000000000004844.","journal-title":"Anesth Analg"},{"key":"2682_CR16","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.tracli.2020.01.004","volume":"27","author":"M Raturi","year":"2020","unstructured":"Raturi M. The journey of blood. Transfus Clin Biol. 2020;27:3. https:\/\/doi.org\/10.1016\/j.tracli.2020.01.004.","journal-title":"Transfus Clin Biol"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02682-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-02682-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02682-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T06:02:49Z","timestamp":1713592969000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-02682-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,20]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2682"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-02682-2","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,20]]},"assertion":[{"value":"1 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Hirosaki University Graduate School of Medicine Institutional Review Board (2021\u2013284); the requirement for individual informed patient consent was waived owing to the retrospective nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"250"}}