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Maurin A, Jacquier A, Bartoli A, Barral PA, Vecchini F, Mancini J, Omnes V, DeMasi M, Piquet P, Gaudry M. STABILISE (Stent-Assisted Balloon-Induced Intimal Disruption and Relamination in Aortic Dissection Repair) Is Associated With Good Anatomical Results on the Distal Thoracoabdominal Aorta at 2 Years. J Endovasc Ther 2024:15266028241232923. [PMID: 38379335 DOI: 10.1177/15266028241232923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
PURPOSE The aim of this comparative study was to evaluate the increased aortic diameter of the distal aorta after implementing the STABILISE technique in complicated type B aortic dissection (AD). DESIGN This is a comparative monocentric retrospective study. MATERIALS AND METHODS All patients who underwent an STABILISE procedure for complicated AD between 2018 and 2020 were included and compared with a historic cohort treated with thoracic endovascular aortic repair (TEVAR) alone. Aortic diameters were measured at 6 different levels on the thoracic and abdominal aorta. The primary end point was an increased aortic diameter at 1 and 2 years. The exclusion criterion was the absence of a computed tomography (CT) scan at 1 or 2 years. RESULTS A total of 55 patients were included: 24 in the TEVAR group and 31 in the STABILISE group. At the level of the stent graft, there was a decrease in aortic diameters in both groups without significant differences. At the level of the distal aorta, there was an increase in aortic diameters in both groups without significant differences. There were significantly more patients in the TEVAR group with an unfavorable increase in aortic diameter >5 mm of the distal aorta at 2 years than in the STABILISE group: 8 (33%) vs 1 (3%) (p=0.01). For chronic ADs, a significantly greater increase in aortic diameters of the distal aorta was observed in the STABILISE group. CONCLUSIONS The STABILISE technique is technically feasible and potentially leads to decreased longer re-intervention rates; indeed, more patients had an unfavorable increase in aortic diameter in the TEVAR group than in the STABILISE group at 2 years. The high rate of long-term distal aortic aneurysm progression and reintervention after TEVAR alone suggests that this option is not sufficient to definitively treat these complex patients. CLINICAL IMPACT This article reported the results of stent assisted balloon induced intimal disruption and relamination (STABILISE) with a follow-up at 2 years. This is the first comparative study between STABILISE, which has emerged as a new technique inducing aortic remodeling and therefore better long-term outcome, and the standard technique TEVAR alone. STABILISE technique is associated with good results on the distal aorta at 2 years with a rate of patient with unfavorable aortic diameter evolution greater in TEVAR group compared to STABILISE group and could improve the long-term results on the distal aorta by inducing extensive aortic remodeling.
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Affiliation(s)
- Arnaud Maurin
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Alexis Jacquier
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Axel Bartoli
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Pierre-Antoine Barral
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Fabien Vecchini
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Julien Mancini
- Aix-Marseille Univ, APHM, INSERM, IRD Biostatistics Department, SESSTIM, BIOSTIC, Marseille, France
| | - Virgile Omnes
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Mariangela DeMasi
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Philippe Piquet
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Marine Gaudry
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
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Marné E, Guimbretière G, Mougin J, Le Corvec T, Guyomarch B, De Beaufort LM, Buschiazzo A, Roussel JC, Maurel B. Comparison of Short and Midterm Aortic Reinterventions in Acute Type A Aortic Dissection Treated by Frozen Elephant Trunk or Conventional Arch Repair. Ann Vasc Surg 2023; 95:3-13. [PMID: 37169252 DOI: 10.1016/j.avsg.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/07/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Long-term outcomes after acute type A aortic dissection (ATAAD) are related to remodelling of the descending thoracic aorta and aortic reinterventions. We compared the impact of an extensive repair at the index procedure using the Frozen Elephant Trunk (FET) technique, versus a conventional arch repair, on long-term remodelling of the descending thoracic and reintervention related to the aorta. METHODS Consecutive patients who underwent conventional arch repair (conventional group) or FET repair (FET group) for an ATAAD from September 2018 to November 2021 were included. Patients who died before discharge or were lost to follow-up prior to the first appointment were excluded from the analysis. Preoperative and postoperative computed tomography angiography was reconstructed and diameter of the true/false lumen of the remaining aorta was compared up to 1 year. Negative (increased total diameter ≥ 5 mm) aortic remodelling was collected for each computed tomography angiography, as well as aortic reinterventions. Comparison of demographic, anatomical, and perioperative complications data were performed using Wilcoxon test for continuous variables or Chi-square test for categorical covariates. The Kaplan-Meier method estimator was used to assess survival rates. The Log rank test was used to compare survival curves between the 2 groups. RESULTS Thirty nine patients were included, 22 in the conventional group and 17 in the FET group (82% males, mean age 60 ± 12 years). In the FET group, distal anastomosis was performed in zone 0 or 1 for 82% of patients using the simplified delivery technique. Median maximum preoperative descending aortic diameter was larger in the FET group (33 mm [30; 37] vs. 30 mm [28; 32] [P = 0.0172]). At 30 days, the rate of negative remodelling on the descending thoracic aorta was significantly higher in the conventional group (50%) than in the FET group (8%, P = 0.02). At 1 year, Kaplan-Meier analysis shown a freedom from descending aortic negative remodeling of 35.1% (95% confidence interval (CI) 18.7-66.1%) in conventional group and 44.9% (CI 95% 26.1-77.2%) in FET group with no significant difference. However, early negative remodelling was observed for the conventional group. Within a year, freedom from reintervention was observed for 74.4% (95% CI 57.1-97%) of patients in the conventional group and 75.5 (95% CI 57.1-99.7%) of patients in the FET group with no significant difference. CONCLUSIONS Negative evolution of descending aorta remains a challenge after ATAAD. An extensive repair using the FET technique during the index procedure seems to be associated with satisfying short-term remodelling of descending aorta.
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Affiliation(s)
- Eglantine Marné
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France
| | - Guillaume Guimbretière
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France
| | - Justine Mougin
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France
| | - Tom Le Corvec
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France; Université de Nantes, Nantes, France
| | | | - Louis Marie De Beaufort
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France
| | - Antoine Buschiazzo
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France
| | - Jean Christian Roussel
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France; Université de Nantes, Nantes, France
| | - Blandine Maurel
- CHU Nantes, L'institut du thorax, service de chirurgie cardiaque et vasculaire, Nantes, France; Université de Nantes, Nantes, France.
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Duan L, Zhang C, Chen X, Wang E, Ye Z, Duan Y, Huang L. Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery. J Pers Med 2023; 13:1296. [PMID: 37763065 PMCID: PMC10532919 DOI: 10.3390/jpm13091296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
The optimal surgical strategy for acute type A aortic dissection (ATAAD) with coronary artery disease (CAD) remains unclear. The goal of this study was to investigate the cardiovascular protective effects of the myocardial priority (MP) strategy or traditional selective cerebral perfusion (SCP) in ATAAD with CAD. A total of 214 adults were analyzed retrospectively, of which 80 underwent the MP strategy intraoperatively. Seventy-nine pairs were propensity-score-matched and divided into SCP and MP groups. The follow-up period ranged from 6 to 36 months. The MP group had a significantly shorter myocardial ischemic time, higher perfusion flow, higher radial artery pressure, and lower incidence of NIRS decrease >20% of the base value, but a longer lower limb circulatory arrest and bypass time than the SCP group. Although similar adverse cardiac and cerebrovascular events were observed in both groups, a shorter posthospital stay, less blood loss and transfusion, higher postoperative hemoglobin, lower creatinine, and higher PaO2/FiO2 were observed in the MP group. Subgroup analysis showed that when the TIMI Risk Score was <4, the MP group had a lower incidence of low cardiac output and lower postoperative cTnI level. The follow-up patients had similar morbidities between the two groups. The novel MP strategy is associated with a shortened myocardial ischemic time, better maintained perfusion of vital organs, and postoperative recovery after surgery for ATAAD combined with non-severe CAD.
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Affiliation(s)
- Lian Duan
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Chengliang Zhang
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xuliang Chen
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - E Wang
- Department of Anesthesiology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China; (E.W.)
| | - Zhi Ye
- Department of Anesthesiology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China; (E.W.)
| | - Yanying Duan
- Department of Occupational and Environmental Health, Public Health School, Central South University, Changsha 410008, China
| | - Lingjin Huang
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
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Porto A, Omnes V, Bartoli MA, Azogui R, Resseguier N, De Masi M, Bal L, Imbert L, Jaussaud N, Morera P, Jacquier A, Barral PA, Gariboldi V, Gaudry M. Reintervention of Residual Aortic Dissection after Type A Aortic Repair: Results of a Prospective Follow-Up at 5 Years. J Clin Med 2023; 12:jcm12062363. [PMID: 36983363 PMCID: PMC10054589 DOI: 10.3390/jcm12062363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
Background After a type A aortic dissection repair, a patent false lumen in the descending aorta is the most common situation encountered, and is a well-known risk factor for aortic growth, reinterventions and mortality. The aim of this study was to analyze the long-term results of residual aortic dissection (RAD) at a high-volume aortic center with prospective follow-up. Methods In this prospective single-center study, all patients operated for type A aortic dissection between January 2017 and December 2022 were included. Patients without postoperative computed tomography scans or during follow-up at our center, and patients without RAD were excluded. The primary endpoint was all-cause mortality during follow-up for patients with RAD. The secondary endpoints were perioperative mortality, rate of distal aneurysmal evolution, location of distal aneurysmal evolution, rate of distal reinterventions, outcomes of distal reinterventions, and aortic-related death during follow-up. Results In total, 200 survivors of RAD comprised the study group. After a mean follow-up of 27.2 months (1-66), eight patients (4.0%) died and 107 (53.5%) had an aneurysmal progression. The rate of distal reintervention was 19.5% (39/200), for malperfusion syndrome in seven cases (3.5%) and aneurysmal evolution in 32 cases (16.0%). Most reinterventions occurred during the first 2 years (82.1%). Twenty-seven patients were treated for an aneurysmal evolution of RAD including aortic arch with hybrid repair in 21 cases and branched aortic arch endoprosthesis in six cases. In the hybrid repair group, there was no death, and the rate of morbidity was 28.6% (6/21) (one minor stroke, one pulmonary complication, one recurrent paralysis with complete recovery and three major bleeding events). In the branched endograft group, there was no death, no stroke, and no paraplegia. There was one case (16.7%) of carotid dissection. Complete aortic remodeling or complete FL thrombosis on the thoracic aorta was found in 18 cases (85.7%) and in five cases (83.3%) in the hybrid and branched endograft groups, respectively. Conclusions: Despite a critical course in most cases of RAD, with a high rate of aneurysmal evolution and reintervention, the long-term mortality rate remains low with a close follow-up and a multidisciplinary management in an expert center.
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Affiliation(s)
- Alizée Porto
- Department of Cardiac Surgery, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Virgile Omnes
- Department of Vascular Surgery, Timone Aortic Center, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Michel A Bartoli
- Department of Vascular Surgery, Timone Aortic Center, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Ron Azogui
- Department of Vascular Surgery, Timone Aortic Center, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Noémie Resseguier
- Department of Epidemiology and Public Health Cost, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Mariangela De Masi
- Department of Vascular Surgery, Timone Aortic Center, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Laurence Bal
- Department of Vascular Surgery, Timone Aortic Center, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Laura Imbert
- Department of Epidemiology and Public Health Cost, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Nicolas Jaussaud
- Department of Cardiac Surgery, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Pierre Morera
- Department of Cardiac Surgery, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Alexis Jacquier
- Department of Radiology, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Pierre-Antoine Barral
- Department of Radiology, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Vlad Gariboldi
- Department of Cardiac Surgery, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Marine Gaudry
- Department of Vascular Surgery, Timone Aortic Center, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
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Gaudry M, Guivier-Curien C, Blanchard A, Porto A, Bal L, Omnes V, De Masi M, Lu C, Jacquier A, Piquet P, Deplano V. Volume Analysis to Predict the Long-Term Evolution of Residual Aortic Dissection after Type A Repair. J Cardiovasc Dev Dis 2022; 9:jcdd9100349. [PMID: 36286301 PMCID: PMC9604488 DOI: 10.3390/jcdd9100349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/26/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background: The aim of this study was to evaluate the aortic diameter and volume during the first year after a type A repair to predict the long-term prognosis of a residual aortic dissection (RAD). Methods: All patients treated in our center for an acute type A dissection with a RAD and follow-up > 3 years were included. We defined two groups: group 1 with dissection-related events (defined as an aneurysmal evolution, distal reintervention, or aortic-related death) and group 2 without dissection-related events. The aortic diameters and volume analysis were evaluated on three postoperative CT scans: pre-discharge (T1), 3−6 months (T2) and 1 year (T3). Results: Between 2009 and 2016, 54 patients were included. Following a mean follow-up of 75.4 months (SD 31.5), the rate of dissection-related events was 62.9% (34/54). The total aortic diameters of the descending thoracic aorta were greater in group 1 at T1, T2 and T3, with greater diameters in the FL (p < 0.01). The aortic diameter evolution at 3 months was not predictive of long-term dissection-related events. The total thoracic aortic volume was significantly greater in group 1 at T1 (p < 0.01), T2 (p < 0.01), and T3 (p < 0.01). At 3 months, the increase in the FL volume was significantly greater in group 1 (p < 0.01) and was predictive for long-term dissection-related events. Conclusion: This study shows that an initial CT scan volume analysis coupled with another at 3 months is predictive for the long-term evolution in a RAD. Based on this finding, more aggressive treatment could be given at an earlier stage.
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Affiliation(s)
- Marine Gaudry
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, 13005 Marseille, France
- Correspondence: ; Tel.: +33-491-388-120
| | | | - Arnaud Blanchard
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, 13005 Marseille, France
| | - Alizée Porto
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, 13005 Marseille, France
- Department of Cardiac Surgery, APHM, Timone Hospital, 13005 Marseille, France
| | - Laurence Bal
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, 13005 Marseille, France
| | - Virgile Omnes
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, 13005 Marseille, France
| | - Mariangela De Masi
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, 13005 Marseille, France
| | - Charlotte Lu
- Department of Radiology, APHM, Timone Hospital, 13005 Marseille, France
| | - Alexis Jacquier
- Department of Radiology, APHM, Timone Hospital, 13005 Marseille, France
| | - Philippe Piquet
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, 13005 Marseille, France
| | - Valerie Deplano
- CNRS, Centrale Marseille, IRPHE, Aix Marseille University, 13013 Marseille, France
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Chen ZX, Jia WN, Jiang YX. Genotype-phenotype correlations of marfan syndrome and related fibrillinopathies: Phenomenon and molecular relevance. Front Genet 2022; 13:943083. [PMID: 36176293 PMCID: PMC9514320 DOI: 10.3389/fgene.2022.943083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Marfan syndrome (MFS, OMIM: 154700) is a heritable multisystemic disease characterized by a wide range of clinical manifestations. The underlying molecular defect is caused by variants in the FBN1. Meanwhile, FBN1 variants are also detected in a spectrum of connective tissue disorders collectively termed as ‘type I fibrillinopathies’. A multitude of FBN1 variants is reported and most of them are unique in each pedigree. Although MFS is being considered a monogenic disorder, it is speculated that the allelic heterogeneity of FBN1 variants contributes to various manifestations, distinct prognoses, and differential responses to the therapies in affected patients. Significant progress in the genotype–phenotype correlations of MFS have emerged in the last 20 years, though, some of the associations were still in debate. This review aims to update the recent advances in the genotype-phenotype correlations of MFS and related fibrillinopathies. The molecular bases and pathological mechanisms are summarized for better support of the observed correlations. Other factors contributing to the phenotype heterogeneity and future research directions were also discussed. Dissecting the genotype-phenotype correlation of FBN1 variants and related disorders will provide valuable information in risk stratification, prognosis, and choice of therapy.
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Affiliation(s)
- Ze-Xu Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wan-Nan Jia
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yong-Xiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Bismuth J, Katsarou M, Trimarchi S. Towards Tailored Imaging Surveillance for Type A Dissection? J Am Coll Cardiol 2021; 78:1872-1874. [PMID: 34696958 DOI: 10.1016/j.jacc.2021.08.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Jean Bismuth
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA.
| | - Maria Katsarou
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA; Section of Vascular Surgery, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Santi Trimarchi
- Section of Vascular Surgery, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical and Community Sciences, University of Milan, Milan, Italy
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Kimura N. Intervention for residual dissection in its early phase-comment on a prospective follow-up study after type A aortic dissection repair: a high rate of distal aneurysmal evolution and reinterventions. Eur J Cardiothorac Surg 2021; 61:160-161. [PMID: 34617980 DOI: 10.1093/ejcts/ezab362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Naoyuki Kimura
- Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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