{
  "abstract": "Objective: Distal anastomotic new entry (DANE) after acute type A aortic dissection repair may contribute to adverse downstream aortic remodelling. This study evaluated the incidence of postoperative DANE and its association with distal aortic growth, reintervention, and clinical outcomes.\n\nDesign: All consecutive patients undergoing type A aortic dissection repair with residual downstream dissection (DeBakey I) between 2011 and 2024 were retrospectively analyzed. Computed tomography angiography was systematically reviewed for DANE using 2-plane distal anastomosis alignment. Longitudinal descending thoracic aortic maximum diameters were analyzed using linear mixed-effects models. Univariable logistic regression, Kaplan-Meier estimates, and Cox proportional hazards analyses were performed.\n\nResults: A total of 164 patients were included, of whom 77 (47.0%) had postoperative DANE. Patients with DANE demonstrated larger distal aortic diameters over time compared with patients without DANE, while baseline diameters were similar (37.6 vs 37.3, P = .77). At 3-5 years, estimated maximum descending thoracic aortic diameter was 51.6 vs 42.7 mm, respectively (P < .001). DANE was associated with ≥10-mm downstream aortic growth, ≥55-mm maximum diameter, and reintervention during 5-year follow-up (combined odds ratio 5.60 [2.48-12.65], P < .001). Overall survival did not differ between groups (hazard ratio 2.04 [0.80-5.18], P = .13). Cox regression demonstrated higher hazard ratios with DANE for reintervention (2.01 [1.01-3.97], P = .04) and reaching ≥55 mm aortic diameter (5.59 [2.33-13.42], P < .001).\n\nConclusions and Relevance: DANE occurred frequently after type A aortic dissection repair and was strongly associated with accelerated downstream aortic growth and reintervention. Routine postoperative assessment and strategies aimed at preventing or treating DANE may improve long-term aortic outcomes.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "Stefan R van Dinter",
      "orcid": "0000-0002-2212-6347"
    },
    {
      "name": "Pim S van Sambeeck",
      "orcid": "0009-0008-0782-9686"
    },
    {
      "name": "Nesar A Hasami",
      "orcid": "0000-0003-2726-7349"
    },
    {
      "name": "Amir H Sadeghi",
      "orcid": "0000-0002-6118-2341"
    },
    {
      "name": "Michel W A Verkroost"
    },
    {
      "name": "Tychon E A Geeraedts"
    },
    {
      "name": "Jan Jaap Janssen",
      "orcid": "0000-0002-4556-1800"
    },
    {
      "name": "Foeke J H Nauta",
      "orcid": "0009-0004-8298-2868"
    },
    {
      "name": "Nabil Saouti",
      "orcid": "0009-0000-3206-5202"
    },
    {
      "name": "Robin H Heijmen",
      "orcid": "0000-0003-1503-2374"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/45xbw1asr0kyr.bib",
  "cited_by": 0,
  "doi": "10.1093/icvts/ivag262",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730567/",
  "id": "45xbw1asr0kyr",
  "issns": [
    "2753-670X"
  ],
  "landing_url": "https://doi.org/10.1093/icvts/ivag262",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00920"
    ],
    [
      "heading",
      "Eacts/115"
    ],
    [
      "heading",
      "Eacts/161"
    ],
    [
      "heading",
      "Eacts/164"
    ],
    [
      "heading",
      "Original article"
    ],
    [
      "heading",
      "Vascular Disease"
    ],
    [
      "openalex",
      "2705|Aortic Disease and Treatment Approaches"
    ]
  ],
  "openalex": "W7214442013",
  "pdf_url": null,
  "pmcid": "PMC13730567",
  "pmid": "42789747",
  "published": "2026-09-25",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/45xbw1asr0kyr.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:23:05Z",
      "native_id": "PMC13730567",
      "source": "pmc",
      "url": "https://doi.org/10.1093/icvts/ivag262"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Aortic Disease and Treatment Approaches",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Distal Anastomotic New Entries After Acute Type A Aortic Dissection Surgery: A Retrospective Cohort Study",
  "title_text": "Distal Anastomotic New Entries After Acute Type A Aortic Dissection Surgery: A Retrospective Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:23:05Z",
  "url": "https://research.draconitic.com/paper/45xbw1asr0kyr",
  "venue": "Interdisciplinary Cardiovascular and Thoracic Surgery",
  "versions": []
}