{"doi":"10.1016/j.xjon.2023.02.015","title":"Progression of distal aorta after endovascular fenestration/stenting in acute type A aortic dissection with malperfusion syndrome","abstract":"ObjectiveThe study objective was to evaluate the progression of dissected distal aorta in patients with acute type A aortic dissection with malperfusion syndrome treated with endovascular fenestration/stenting and delayed open aortic repair.MethodsFrom 1996 to 2021, 927 patients presented with acute type A aortic dissection. Of these, 534 had DeBakey I dissection with no malperfusion syndrome and underwent emergency open aortic repair (no malperfusion syndrome group), whereas 97 patients with malperfusion syndrome underwent fenestration/stenting and delayed open aortic repair (malperfusion syndrome group). Sixty-three patients with malperfusion syndrome treated with fenestration/stenting were excluded due to no open aortic repair, including death from organ failure (n = 31), death from aortic rupture (n = 16), and discharged alive (n = 16).ResultsCompared with the no malperfusion syndrome group, the malperfusion syndrome group had more patients with acute renal failure (60% vs 4.3%, P < .001). Both groups had similar aortic root and arch procedures. Postoperatively, the malperfusion syndrome group had similar operative mortality (5.2% vs 7.9%, P = .35) and permanent dialysis (4.7% vs 2.9%, P = .50), but more new-onset dialysis (22% vs 7.7%, P < .001) and prolonged ventilation (72% vs 49%, P < .001). The growth rate of the aortic arch (0.38 vs 0.35 mm/year, P = .81) was similar between the malperfusion syndrome and no malperfusion syndrome groups. The descending thoracic aorta growth rate (1.03 vs 0.68 mm/year, P = .001) and abdominal aorta growth rate (0.76 vs 0.59 mm/year, P = .02) were significantly higher in the malperfusion syndrome group. The cumulative incidence of reoperation over 10 years (18% vs 18%, P = .81) and 15-year survival outcome (50% vs 48%, P = .43) were similar between the malperfusion syndrome and no malperfusion syndrome groups.ConclusionsEndovascular fenestration/stenting followed by delayed open aortic repair was a valid approach for patients with malperfusion syndrome.","journal":"JTCVS Open","year":2023,"id":349219,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9501,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":760882,"name":"Felix Orelaru","orcid":"0000-0001-7591-1835","position":1,"is_corresponding":false},{"id":783984,"name":"Nathan J. Graham","orcid":"0000-0002-2648-4838","position":2,"is_corresponding":false},{"id":961781,"name":"Marc Titsworth","orcid":null,"position":3,"is_corresponding":false},{"id":974076,"name":"Katelyn Monaghan","orcid":"0000-0003-2163-0602","position":4,"is_corresponding":false},{"id":77478,"name":"Xiaoting Wu","orcid":"0000-0002-3996-868X","position":5,"is_corresponding":false},{"id":262056,"name":"Karen M. Kim","orcid":"0000-0002-5641-7572","position":6,"is_corresponding":false},{"id":262052,"name":"Shinichi Fukuhara","orcid":"0000-0002-7898-5159","position":7,"is_corresponding":false},{"id":425831,"name":"Himanshu J. Patel","orcid":"0000-0001-7639-2416","position":8,"is_corresponding":false},{"id":1092895,"name":"G Michael Deeb","orcid":null,"position":9,"is_corresponding":false},{"id":1021578,"name":"Bo Yang","orcid":"0000-0003-0127-9632","position":10,"is_corresponding":false},{"id":948746,"name":"Rana‐Armaghan Ahmad","orcid":null,"position":0,"is_corresponding":true}],"reference_count":17,"raw_metadata":null,"created_at":"2026-07-19T01:12:14.919810Z","pmid":"37425443","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}