{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T11:54:32Z","timestamp":1766577272471,"version":"3.48.0"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"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":["82200499"],"award-info":[{"award-number":["82200499"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Affiliated Drum Tower Hospital","award":["2022-LCYJ-PY-31"],"award-info":[{"award-number":["2022-LCYJ-PY-31"]}]},{"name":"Affiliated Drum Tower Hospital","award":["2022-LCYJ-PY-50"],"award-info":[{"award-number":["2022-LCYJ-PY-50"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Optimal cerebral protection strategies for acute Stanford type A aortic dissection (aTAAD) surgery remain controversial. This study aimed to evaluate the role of near-infrared spectroscopy (NIRS)-guided monitoring and its association with clinical outcomes. Methods: We retrospectively analyzed 619 patients undergoing aTAAD surgery (Hemi-Arch, Total-Arch, or Arch-Stent procedures). Intraoperative cerebral oxygenation was monitored using NIRS, with the magnitude of desaturation quantified as \u0394NIRS. We assessed correlations between \u0394NIRS and nasopharyngeal temperature, employed generalized additive models (GAM) to analyze nonlinear relationships with major adverse cardiovascular events (MACE), and used piecewise logistic regression to identify procedure-specific \u0394NIRS risk thresholds. Results: \u0394NIRS showed a significant positive correlation with lower temperatures in Total-Arch (R = 0.486, p &lt; 0.001) and Arch-Stent (R = 0.216, p &lt; 0.001) groups. GAM analysis revealed a nonlinear, accelerating relationship between higher \u0394NIRS and increased log odds of MACE in Hemi-Arch and Total-Arch groups. Procedure-specific \u0394NIRS thresholds were identified: 8.5% for Hemi-Arch, 19.6% for Total-Arch, and 20.9% for Arch-Stent. Patients with \u0394NIRS above these thresholds had significantly higher rates of stroke and MACE. Conclusions: This study identifies \u0394NIRS as a significant, procedure-dependent intraoperative monitoring indicator in aTAAD surgery, and the proposed risk thresholds provide a rationale for real-time NIRS-guided clinical decision-making.<\/jats:p>","DOI":"10.3390\/jcdd13010012","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T11:22:14Z","timestamp":1766575334000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Cerebral Protection and Monitoring of Acute Stanford Type A Aortic Dissection: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-0699","authenticated-orcid":false,"given":"Yi","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, Graduate School of Peking Union Medical College, Chinese Academy of Medical Science & Peking Union Medical College, Peking Union Medical College Graduate School, Nanjing 210008, China"},{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"},{"name":"Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, Graduate School of Peking Union Medical College, Chinese Academy of Medical Science & Peking Union Medical College, Peking Union Medical College Graduate School, Nanjing 210008, China"},{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"},{"name":"Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"},{"name":"Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Mi","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongqing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"},{"name":"Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoshun","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"},{"name":"Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongjin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, Graduate School of Peking Union Medical College, Chinese Academy of Medical Science & Peking Union Medical College, Peking Union Medical College Graduate School, Nanjing 210008, China"},{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"},{"name":"Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunxing","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China"},{"name":"Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1016\/j.jacc.2020.07.061","article-title":"Type A Aortic Dissection-Experience Over 5 Decades: JACC Historical Breakthroughs in Perspective","volume":"76","author":"Zhu","year":"2020","journal-title":"J. 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Surg."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/1\/12\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T11:51:30Z","timestamp":1766577090000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/1\/12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcdd13010012"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13010012","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,24]]}}}