{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:32:15Z","timestamp":1770744735237,"version":"3.49.0"},"reference-count":104,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The purpose of this narrative review was to detail and discuss the underlying principles and benefits of preoperative interventions addressing risk factors for perioperative adverse events in open aortic surgery (OAS). The term \u201ccomplex aortic disease\u201d encompasses juxta\/pararenal aortic and thoraco-abdominal aneurysms, chronic aortic dissection and occlusive aorto-iliac pathology. Although endovascular surgery has been increasingly favored, OAS remains a durable option, but by necessity involves extensive surgical approaches and aortic cross-clamping and requires a trained multidisciplinary team. The physiological stress of OAS in a fragile and comorbid patient group mandates thoughtful preoperative risk assessment and the implementation of measures dedicated to improving outcomes. Cardiac and pulmonary complications are one of the most frequent adverse events following major OAS and their incidences are correlated to the patient\u2019s functional status and previous comorbidities. Prehabilitation should be considered in patients with risk factors for pulmonary complications including advanced age, previous chronic obstructive pulmonary disease, and congestive heart failure with the aid of pulmonary function tests. It should also be combined with other measures to improve postoperative course and be included in the more general concept of enhanced recovery after surgery (ERAS). Although the current level of evidence regarding the effectiveness of ERAS in the setting of OAS remains low, an increasing body of literature has promoted its implementation in other specialties. Consequently, vascular teams should commit to improving the current evidence through studies to make ERAS the standard of care for OAS.<\/jats:p>","DOI":"10.3390\/jcm12113691","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:17:33Z","timestamp":1685204253000},"page":"3691","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Benefits of Prehabilitation before Complex Aortic Surgery"],"prefix":"10.3390","volume":"12","author":[{"given":"Thomas","family":"Mesnard","sequence":"first","affiliation":[{"name":"Service de Chirurgie Vasculaire, Centre de l\u2019Aorte, CHU Lille, 59000 Lille, France"},{"name":"Univ. Lille, INSERM U1008\u2014Advanced Drug Delivery Systems and Biomaterials, 59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5457-8807","authenticated-orcid":false,"given":"Maxime","family":"Dubosq","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Vasculaire, Centre de l\u2019Aorte, CHU Lille, 59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Pruvot","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Vasculaire, Centre de l\u2019Aorte, CHU Lille, 59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Azzaoui","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Vasculaire, Centre de l\u2019Aorte, CHU Lille, 59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin O.","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Southampton, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2926-9225","authenticated-orcid":false,"given":"Jonathan","family":"Sobocinski","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Vasculaire, Centre de l\u2019Aorte, CHU Lille, 59000 Lille, France"},{"name":"Univ. Lille, INSERM U1008\u2014Advanced Drug Delivery Systems and Biomaterials, 59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.ejvs.2019.11.030","article-title":"Editor\u2019s Choice-Endovascular vs. Open Repair for Abdominal Aortic Aneurysm: Systematic Review and Meta-analysis of Updated Peri-operative and Long Term Data of Randomised Controlled Trials","volume":"59","author":"Antoniou","year":"2020","journal-title":"Eur. J. Vasc. Endovasc. Surg. Off. J. Eur. Soc. Vasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1016\/j.jvs.2014.01.007","article-title":"Epidemiology of aortic aneurysm repair in the United States from 2000 to 2010","volume":"59","author":"Dua","year":"2014","journal-title":"J. Vasc. 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