{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:59:17Z","timestamp":1787025557495,"version":"build-2736575974"},"reference-count":23,"publisher":"IMR Press","issue":"7","license":[{"start":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T00:00:00Z","timestamp":1656028800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background and Aim of the Study: In patients with acute type A aortic dissection (A-AAD) whether initial repair should include also aortic arch replacement is still debated. We aimed to assess if extensive aortic repair prevents from reoperations patients with A-AAD. Methods: Outcomes after distal reoperation following repair of A-AAD (n = 285; 1977 to 2018) were analysed in 22 of 226 who underwent ascending aorta\/hemiarch replacement (Group 1R) and 7 of 59 who had ascending aorta\/arch replacement (Group 2R). Results: Distal reoperation was more common in Group 1R (n = 22) than in Group 2R (n = 0) (p &lt; 0.001) while thoracic endovascular stenting was more frequent in Group 2R (7 vs 3, p &lt; 0.001). Indications for reoperation were pseudoaneurysm at distal anastomosis (n = 4, 18%) and progression of aortic dissection (n = 18, 82%) in Group 1R. Indication for thoracic endovascular stenting was progressive aortic dissection in 3 patients of Group 1R and in 6 of Group 2R. Second reoperation was required in 2 patients from Group 1R (2%) during a mean follow-up of 5 years. Median follow-up was 4 years in Group 1R and 7 years in Group 2R (p = 0.36). Hospital mortality was 14% in Group 1R and 0% in Group 2R (p = 0.3). Actuarial survival is 68 \u00b1 10%, and 62 \u00b1 11% for Group 1R and 100% for Group 2R at 5 and 10 years (p = 0.076). Conclusions: Distal reoperations after A-AAD repair have an acceptable mortality. An extensive initial repair has lower rate of reoperation and better mid-term survival and should be indicated especially for young patients in experienced centers.<\/jats:p>","DOI":"10.31083\/j.rcm2307228","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T05:09:30Z","timestamp":1656047370000},"source":"Crossref","is-referenced-by-count":6,"title":["Distal Reoperations after Repair of Acute Type A Aortic Dissection\u2014Incidence, Causes and Outcomes"],"prefix":"10.31083","volume":"23","author":[{"given":"Igor","family":"Vendramin","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Piani","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lechiancole","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Sponga","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Muser","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Imazio","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Onorati","sequence":"first","affiliation":[{"name":"Azienda Ospedaliero-Universitaria di Verona, Cardiothoracic and Vascular Department, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Auci","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uberto","family":"Bortolotti","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugolino","family":"Livi","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Via Pozzuolo 11, 33100 Udine, Italy"},{"name":"Department of Medical Area (DAME), University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Rylski B, Beyersdorf F, Kari FA, Sclosser J, Blanke P, Siepe M. 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