{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:42:19Z","timestamp":1788795739617,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Acute Stanford type A aortic dissection (STAAD) is a fatal condition requiring urgent surgical intervention. Owing to the complexity of the surgical process, various complications, such as neurological disorders, are common. In this study, we prioritized the reconstruction of aortic arch branches during surgery and investigated the association between prioritizing the branches and the postoperative outcomes of patients with STAAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety-seven patients were included in the observational study and underwent total arch replacement and frozen elephant trunk technique between January 2018 and June 2021. Of these, 35 patients underwent the branch-priority technique, and 62 patients underwent the classic technique. By analyzing the perioperative outcomes, we compared the differences between the two techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The branch priority group had significantly shorter cardiopulmonary bypass and ventilator times and earlier postoperative wake-up times than the classic group. Additionally, the ICU stay time was shorter, with a significant decrease in neurological complications and 24\u2005h drainage in the branch priority group compared to the classic group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The branch priority technique can effectively provide better brain protection, resulting in earlier awakening of patients after surgery, reduced neurological complications, shorter ventilation time and decreased ICU hospitalization time. Therefore, it is recommended for use in aortic dissection surgeries.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1321700","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T04:27:05Z","timestamp":1705984025000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery"],"prefix":"10.3389","volume":"10","author":[{"given":"Jianfeng","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjian","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifang","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilin","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyou","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxian","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1093\/eurheartj\/ehac757","article-title":"Acute aortic dissection: evidence, uncertainties, and future therapies","volume":"44","author":"Rylski","year":"2023","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1016\/S0140-6736(22)01970-5","article-title":"Acute aortic dissection","volume":"401","author":"Carrel","year":"2023","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"372","DOI":"10.23736\/S0392-9590.22.04924-0","article-title":"Mortality and neurologic complications after repair of aortic arch pathology with elephant trunk procedures: a systematic review with meta-analysis","volume":"41","author":"Ferreira","year":"2022","journal-title":"Int Angiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1093\/icvts\/ivaa321","article-title":"Aortic arch surgery at 32\u00b0C: mild hypothermia and unilateral antegrade cerebral perfusion","volume":"32","author":"Jabagi","year":"2021","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1093\/ejcts\/ezab192","article-title":"Neuroprotective strategies in acute aortic dissection: an analysis of the UK national adult cardiac surgical audit","volume":"60","author":"Benedetto","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e017939","DOI":"10.1161\/JAHA.120.017939","article-title":"Effect of deep hypothermic circulatory arrest versus moderate hypothermic circulatory arrest in aortic arch surgery on postoperative renal function: a systematic review and meta-analysis","volume":"9","author":"Cao","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.mcna.2021.12.003","article-title":"Delirium","volume":"106","author":"Keenan","year":"2022","journal-title":"Med Clin North Am"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1001\/jamacardio.2022.2718","article-title":"Early mortality in type A acute aortic dissection: insights from the international registry of acute aortic dissection","volume":"7","author":"Harris","year":"2022","journal-title":"JAMA Cardiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"988619","DOI":"10.3389\/fcvm.2022.988619","article-title":"Outcomes of hemi- vs. Total arch replacement in acute type A aortic dissection: a systematic review and meta-analysis","volume":"9","author":"Ma","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"623","DOI":"10.21037\/cdt-23-144","article-title":"Frozen elephant trunk: the gold standard","volume":"13","author":"Bashir","year":"2023","journal-title":"Cardiovasc Diagn Ther"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1016\/j.jtcvs.2020.10.135","article-title":"Total arch replacement and frozen elephant trunk for acute type A aortic dissection","volume":"164","author":"Iino","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1089\/ther.2022.0037","article-title":"Fibrinolysis in cardiac arrest patients treated with hypothermia","volume":"13","author":"Jeppesen","year":"2023","journal-title":"Ther Hypothermia Temp Manag"},{"key":"B13","doi-asserted-by":"publisher","first-page":"668333","DOI":"10.3389\/fcvm.2021.668333","article-title":"Optimal degree of hypothermia in total arch replacement for type A aortic dissection","volume":"8","author":"Wu","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1177\/02676591221095468","article-title":"Unilateral versus bilateral anterograde cerebral perfusion in acute type A aortic dissection repair: a systematic review and meta-analysis","volume":"38","author":"Tasoudis","year":"2023","journal-title":"Perfusion"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2271","DOI":"10.3390\/jcm12062271","article-title":"Cerebral protection strategies and stroke in surgery for acute type A aortic dissection","volume":"12","author":"Pitts","year":"2023","journal-title":"J Clin Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1177\/02184923221074409","article-title":"Prevention and management of difficult hemostasis in acute type A aortic dissection repair","volume":"31","author":"Lee","year":"2023","journal-title":"Asian Cardiovasc Thorac Ann"},{"key":"B17","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/S0003-4975(03)01342-0","article-title":"Technical advances in total aortic arch replacement","volume":"77","author":"Strauch","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"S1810","DOI":"10.1016\/S0003-4975(02)04156-5","article-title":"Aortic arch replacement using a trifurcated graft and selective cerebral antegrade perfusion","volume":"74","author":"Spielvogel","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3234","DOI":"10.1364\/BOE.484044","article-title":"Review of recent advances in frequency-domain near-infrared spectroscopy technologies [invited]","volume":"14","author":"Zhou","year":"2023","journal-title":"Biomed Opt Express"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2676591221144169","DOI":"10.1177\/02676591221144169","article-title":"Clinical outcomes of mild versus moderate hypothermic circulatory arrest with antegrade cerebral perfusion in adult aortic arch surgery: a systematic review and meta-analysis","author":"Wang","year":"2022","journal-title":"Perfusion"},{"key":"B21","doi-asserted-by":"publisher","first-page":"680.e1","DOI":"10.1016\/j.ajem.2015.06.057","article-title":"Paraplegia caused by aortic coarctation complicated with spinal epidural hemorrhage","volume":"34","author":"Tsai","year":"2016","journal-title":"Am J Emerg Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.jtcvs.2018.08.111","article-title":"Untreated distal intimal tears may be associated with paraplegia after total arch replacement and frozen elephant trunk treatment of acute Stanford type A aortic dissection","volume":"158","author":"Tan","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1093\/ejcts\/ezt252","article-title":"Experience with the conventional and frozen elephant trunk techniques: a single-centre study","volume":"44","author":"Leontyev","year":"2013","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1321700\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T10:26:21Z","timestamp":1706523981000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1321700\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,23]]},"references-count":23,"alternative-id":["10.3389\/fcvm.2023.1321700"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1321700","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,23]]},"article-number":"1321700"}}