{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T15:15:29Z","timestamp":1783610129785,"version":"3.55.0"},"reference-count":14,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Patients with thoracic aortic disease (TAD) frequently seek advice on the safety of commercial air travel. Despite the clinical relevance of this question, robust evidence is virtually absent, and current recommendations rely largely on expert opinion. This Viewpoint discusses the physiological effects of flights, reviews the limited available evidence, and proposes a pragmatic, risk-based approach for clinicians counselling patients with TAD.<\/jats:p>","DOI":"10.3390\/jcdd13070319","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T14:17:51Z","timestamp":1783606671000},"page":"319","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Commercial Air Travel Safe in Thoracic Aortic Disease? A Physiological and Clinical Perspective"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9981-8336","authenticated-orcid":false,"given":"Nimrat","family":"Grewal","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Amsterdam University Medical Center Location AMC, Meibergdreef 9, 1105 Amsterdam, The Netherlands"},{"name":"Aortic Institute at Yale New Haven Hospital, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6255-8139","authenticated-orcid":false,"given":"John A.","family":"Elefteriades","sequence":"additional","affiliation":[{"name":"Aortic Institute at Yale New Haven Hospital, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8789-5561","authenticated-orcid":false,"given":"Matthew M.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Peak Aerospace Medicine & Cardiovascular Surgery, Lake Elmo, MN 55042, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"ezad426","DOI":"10.1093\/ejcts\/ezad426","article-title":"EACTS\/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ","volume":"65","author":"Czerny","year":"2024","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_2","unstructured":"Aerospace Medical Association Medical Guidelines Task Force (2003). Medical guidelines for airline travel. Aviat. Space Environ. Med., 74, A1\u2013A19."},{"key":"ref_3","unstructured":"International Air Transport Association (2024). Medical Manual, IATA. [14th ed.]."},{"key":"ref_4","first-page":"ii1","article-title":"Fitness to fly for passengers with cardiovascular disease: The report of a working group of the British Cardiovascular Society","volume":"96","author":"Smith","year":"2010","journal-title":"Heart (Br. Card. Soc.)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1136\/thoraxjnl-2011-200295","article-title":"Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations","volume":"66","author":"Ahmedzai","year":"2011","journal-title":"Thorax"},{"key":"ref_6","first-page":"1507","article-title":"Cardiovascular disease and airline travel","volume":"93","author":"Joy","year":"2007","journal-title":"Heart (Br. Card. Soc.)"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1001\/jama.1988.03720130047028","article-title":"In-flight deaths during commercial air travel: How big is the problem?","volume":"259","author":"Cummins","year":"1988","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1146\/annurev.publhealth.24.100901.140853","article-title":"Health issues of air travel","volume":"24","author":"DeHart","year":"2003","journal-title":"Annu. Rev. 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Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.amj.2014.02.006","article-title":"Air travel of patients with abdominal aortic aneurysm: Urgent air medical evacuation and nonurgent commercial air repatriation","volume":"33","author":"Barros","year":"2014","journal-title":"Air Med. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1093\/eurheartj\/ehx760","article-title":"Blood pressure variability and risk of cardiovascular events and death in patients with hypertension and different baseline risks","volume":"39","author":"Mehlum","year":"2018","journal-title":"Eur. 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