{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:22:53Z","timestamp":1760145773684,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: The aims of this study were to assess the perioperative morbidity, mortality and long-term survival of octogenarians undergoing acute type A aortic dissection repair (ATAAD), and to compare open and closed distal anastomosis techniques. Methods: This was a single-centre retrospective study (2007\u20132021). Open versus closed distal anastomosis were compared. Uni- and multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. Kaplan\u2013Meier and Cox proportional hazards methods were used to compare long-term survival. Results: Fifty octogenarian patients were included (median age\u201482 years; closed distal\u201422; open distal\u201428). Median cardiopulmonary bypass time was 187 min (open distal vs. closed distal group; 219 min vs. 115.5 min, p &lt; 0.01, respectively). Median cross-clamp time was 93 min (IQR; 76\u2013130 min). Median circulatory arrest time was 26 min (IQR; 20\u201339 min) in the open-distal group. In-hospital mortality was 18% (open distal; 14.2% vs. closed distal; 22.7%, p = 0.44). Stroke was 26% (open distal; 28.6% vs. closed distal; 22.7%, p = 0.64). Median survival was 7.2 years (IQR; 4.5\u201311.6 years). Survival was comparable between open and closed distal groups (median 10.6 vs. 7.2 years, p = 0.35, respectively). Critical preoperative status (HR; 3.2, p = 0.03) and composite endpoint (renal replacement therapy, new neurological event, length of stay &gt; 30 days or return to theatre; HR; 4.1, p = 0.02) predicted adverse survival. Open distal anastomosis did no impact survival. Conclusions: ATAAD repair in selected octogenarians has acceptable short- and long-term survival. There is no significant difference between open versus closed distal anastomosis strategies.<\/jats:p>","DOI":"10.3390\/medsci12030045","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T10:07:35Z","timestamp":1725271655000},"page":"45","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative and Long-Term Outcomes of Acute Stanford Type A Aortic Dissection Repair in Octogenarians"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9101-849X","authenticated-orcid":false,"given":"Hannah","family":"Masraf","sequence":"first","affiliation":[{"name":"Division of Surgery, Kingston Hospital NHS Foundation Trust, Kingston upon Thames KT2 7QB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manoraj","family":"Navaratnarajah","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Division of Cardiac Surgery, Southampton University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8394-0422","authenticated-orcid":false,"given":"Laura","family":"Viola","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Division of Cardiac Surgery, Southampton University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5053-3815","authenticated-orcid":false,"given":"Davorin","family":"Sef","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Division of Cardiac Surgery, Southampton University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-2670","authenticated-orcid":false,"given":"Pietro G.","family":"Malvindi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali Riuniti delle Marche, Polytechnic University of Marche, 60126 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Szabolcs","family":"Miskolczi","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Division of Cardiac Surgery, Southampton University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodore","family":"Velissaris","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Division of Cardiac Surgery, Southampton University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7911-1894","authenticated-orcid":false,"given":"Suvitesh","family":"Luthra","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Division of Cardiac Surgery, Southampton University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK"},{"name":"Department of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"ref_1","unstructured":"(2023, May 18). 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