{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:55:43Z","timestamp":1783468543378,"version":"3.55.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81770466"],"award-info":[{"award-number":["81770466"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Stanford type A aortic dissection (STAAD) is often associated with coronary artery problems requiring coronary artery bypass grafting (CABG). However, the prognosis of different proximal graft locations remains unclear.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> From May 2015 to April 2020, 62 patients with acute STAAD who underwent aortic surgery concomitant with CABG were enrolled in our study. Aortic bypass was defined as connecting the proximal end of the vein bridge to the artificial aorta (SVG-AO); non-aortic bypass was defined as connecting the proximal end of the vein bridge to a non-aorta vessel, including left subclavian artery, left common carotid artery, and right brachiocephalic artery (non-SVG-AO). We compared early- and mid-term results between patients in the above two groups. Early results included death and bleeding, and mid-term results graft patency, aortic-related events, and bleeding. Grafts were evaluated by post-operative coronary computed tomography angiography. According to the Fitzgibbon classification, grade A (graft stenosis &amp;lt;50%) is considered a patent graft. Univariate and multivariate analyses were performed to assess differences between aortic and non-aortic bypass in STAAD.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> SVG-AO and non-SVG-AO were performed in 15 and 47 patients, respectively. There was no significant difference in death (log-rank test, <jats:italic>p<\/jats:italic> = 0.426) or bleeding (<jats:italic>p<\/jats:italic> = 0.766) between the two groups in the short term. One year of follow-up was completed in 37 patients (eight in the SVG-AO group and 29 in the non-SVG-AO group), among which 14\/15 (93.3%) grafts were patent in the SVG-AO group and 32\/33 (97.0%) grafts in the non-SVG-AO at 1 week, without a significant difference (<jats:italic>p<\/jats:italic> = 0.532). At 3 months, 12\/13 (92.3%) grafts were patent in the SVG-AO group and 16\/32 (50.0%) grafts in the non-SVG-AO, with a significant difference (<jats:italic>p<\/jats:italic> = 0.015), and 12\/13 (92.3%) grafts in the SVG-AO group and 15\/32 (46.9%) grafts in the non-SVG-AO group were patents, with a significant difference. Multivariate analysis showed proximal aortic bypass and dual anticoagulation to be protective factors for the 1-year patency of grafts.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> In patients requiring aortic dissection surgery with concomitant CABG, no differencess' between SVG-AO and SVG-non-AO in early outcomes were detected, but SVG-AO may have higher mid-term patency.<\/jats:p>","DOI":"10.3389\/fcvm.2021.743562","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T06:12:30Z","timestamp":1635228750000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Mid-term Patency of the Great Saphenous Bypass to Aorta vs. Non-aortic Arteries in Stanford Type A Aortic Dissection Surgery With Concomitant CABG"],"prefix":"10.3389","volume":"8","author":[{"given":"Maozhou","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songhao","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Pu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4063","DOI":"10.1016\/j.ijcard.2013.07.031","article-title":"Acute aortic dissection type A with acute coronary involvement: a novel classification","volume":"168","author":"Chen","year":"2013","journal-title":"Int J Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s13019-021-01469-z","article-title":"Short-term outcomes of acute coronary involvement in type A aortic dissection without myocardial ischemia: a multiple center retrospective cohort study","volume":"16","author":"Wang","year":"2021","journal-title":"J Cardiothorac Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1016\/j.athoracsur.2018.09.065","article-title":"Management of patients with coronary artery malperfusion secondary to type A aortic dissection","volume":"107","author":"Kreibich","year":"2019","journal-title":"Ann Thorac Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1016\/j.ajem.2017.05.010","volume":"35","author":"Zhu","year":"2017","journal-title":"Am J Emerg Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1016\/S0003-4975(03)00899-3","article-title":"Coronary malperfusion due to type A aortic dissection: mechanism and surgical management","volume":"76","author":"Kawahito","year":"2003","journal-title":"Ann Thorac Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1177\/1526602817721674","article-title":"Sandwich technique for endovascular repair of acute type A aortic dissection","volume":"24","author":"Gao","year":"2017","journal-title":"J Endovasc Ther."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e329","DOI":"10.1016\/j.athoracsur.2018.05.076","article-title":"Adventitial wrap technique for acute type A aortic dissection","volume":"106","author":"Koshiyama","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.1016\/j.athoracsur.2011.03.110","article-title":"Wrapping of the ascending aorta in acute type A retrograde aortic dissection","volume":"92","author":"Ramadan","year":"2011","journal-title":"Ann Thorac Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1016\/j.jtcvs.2018.12.082","article-title":"Is it justified to apply a modified cabrol fistula in surgical repair of acute type A aortic dissection?","volume":"158","author":"Zhang","year":"2019","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.1016\/j.jacc.2013.10.085","article-title":"Outcomes of acute type a dissection repair before and after implementation of a multidisciplinary thoracic aortic surgery program","volume":"63","author":"Andersen","year":"2014","journal-title":"J Am Coll Cardiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1016\/j.jtcvs.2019.01.028","article-title":"Commentary: to wrap or not to wrap-have we now come full circle?","volume":"158","author":"Galla","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1161\/01.CIR.76.5.1092","article-title":"Analysis of flow characteristics in poststenotic regions of the human coronary artery during bypass graft surgery","volume":"76","author":"Kajiya","year":"1987","journal-title":"Circulation."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2628","DOI":"10.1016\/j.jacc.2015.04.030","article-title":"The impact of pre-operative malperfusion on outcome in acute type A aortic dissection: results from the GERAADA registry","volume":"65","author":"Czerny","year":"2015","journal-title":"J Am Coll Cardiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.jtcvs.2018.10.134","article-title":"Malperfusion in acute type A aortic dissection: an update from the nordic consortium for acute type A aortic dissection","volume":"157","author":"Zindovic","year":"2019","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2021.03.043","article-title":"Concomitant coronary artery bypass in patients with acute type A aortic dissection","author":"Morjan","year":"2021","journal-title":"Semin Thorac Cardiovasc Surg."},{"key":"B16","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/j.asjsur.2021.01.031","article-title":"Concomitant coronary artery bypass grafting during surgical repair of acute type A aortic dissection affects operative mortality rather than midterm mortality","volume":"44","author":"Zhang","year":"2021","journal-title":"Asian J Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1067\/mtc.2001.112534","article-title":"Proximal aortic dissection with coronary malperfusion: presentation, management, and outcome","volume":"121","author":"Neri","year":"2001","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1475-925X-7-9","article-title":"Influence on fluid dynamics of coronary artery outlet angle variation in artificial aortic root prosthesis","volume":"7","author":"Verhey","year":"2008","journal-title":"Biomed Eng Online"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2680","DOI":"10.1161\/CIRCULATIONAHA.110.978007","article-title":"Aspirin plus clopidogrel versus aspirin alone after coronary artery bypass grafting: the clopidogrel after surgery for coronary artery disease (CASCADE) trial","volume":"122","author":"Kulik","year":"2010","journal-title":"Circulation."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1016\/j.athoracsur.2011.04.107","article-title":"Statin therapy and saphenous vein graft disease after coronary bypass surgery: analysis from the CASCADE randomized trial","volume":"92","author":"Kulik","year":"2011","journal-title":"Ann Thorac Surg."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.743562\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T06:12:33Z","timestamp":1635228753000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.743562\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,26]]},"references-count":20,"alternative-id":["10.3389\/fcvm.2021.743562"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.743562","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,26]]},"article-number":"743562"}}