ArticleThe Annals of thoracic surgery2025
Malperfusion in Patients With Acute Type A Aortic Dissection: A Nationwide Analysis.
Article in The Annals of thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Surgical strategies in elderly patients with acute type A aortic dissection-a systematic review.Frontiers in surgery · 2026Pooled it
- Cerebral malperfusion resolution after repair of acute DeBakey type I dissection with a novel hybrid prosthesis: early results of the PERSEVERE Study†.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Trial
- Performance and incremental value of preoperative multimodal imaging and perioperative clinical characteristics in predicting postoperative major adverse events in type A aortic dissection.Quantitative imaging in medicine and surgery · 2026Article
- Staged visceral revascularization prior to central aortic repair in acute type A aortic dissection complicated by mesenteric malperfusion: a case report.European heart journal. Case reports · 2026Article
- Left main ostium dissection due to the ATAAD with coronary malperfusion.Journal of cardiothoracic surgery · 2026Article
- Impact of Malperfusion Burden on Early Outcomes After Surgery for Type A Acute Aortic Dissection: A Retrospective, Single-Center Investigation.Journal of clinical medicine · 2026Article
- The GERAADA Risk Score for Early Mortality After Surgery for Acute Type A Aortic Dissection: An External Validation in the Dutch Setting.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- 2025 report on advances in thoracic aortic disease research.Journal of thoracic disease · 2026Review
- Femoral Arterial Perfusion Guided by Intraoperative Transesophageal Echocardiography for Mesenteric Malperfusion in Acute Type A Aortic Dissection.Annals of vascular diseases · 2026Article
- Interplay between acute Type A aortic dissection and pan-cancer: Clinical evidence, bioinformatics, and experimental validation.iScience · 2025Article
- Peripheral veno-arterial extracorporeal membrane oxygenation as a bridge to surgery in type A aortic dissection: a review on strategic approach to managing malperfusion syndrome.The journal of extra-corporeal technology · 2025Review
- Emergency central aortic repair in acute type A aortic dissection complicated by malperfusion.Frontiers in surgery · 2025Article
- Research progress on endovascular treatment of Stanford Type A aortic dissection.Frontiers in cardiovascular medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
backgroundThis study describes in detail the clinical burden of malperfusion associated with acute type A aortic dissection (ATAAD) in a large, national cohort and the effect of treatment strategy on outcomes.
methodsAll patients undergoing repair of ATAAD between 2017 and 2020 in The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database were studied. Malperfusion was defined using STS definitions on the basis of imaging or the surgeon's evaluation. Multivariable logistic regression was used to analyze the effect of patient and treatment factors on outcomes in patients with and without malperfusion.
resultsA total of 9958 patients undergoing ATAAD repair were studied. Preoperative malperfusion occurred in 27.7% (2748 of 9958) of cases and most often involved the extremity (14.9%; 1484 of 9958), renal (10.2%), or cerebral (9.8%) vascular beds. Operative mortality was much greater among patients with malperfusion (26.8% vs 13.6%; P < .001). After adjustment, coronary malperfusion was associated with the highest odds of mortality (odds ratio, 2.28; 95% CI, 1.85-2.81; P < .001) followed by mesenteric malperfusion (odds ratio, 1.82; 95% CI, 1.45-2.28; P < .001). Cerebral malperfusion was not independently associated with significantly increased odds of mortality (odds ratio, 1.14; 95% CI, 0.94-1.38; P = .18). Partial arch replacement (zone 1 or zone 2) compared with ascending aorta or hemiarch replacement only showed a similar rate of mortality in patients with malperfusion (24.8% vs 26.9%; P = .99) and without malperfusion (11.6% vs 13.6%; P = .54).
conclusionsPreoperative malperfusion in ATAAD was common and associated with significant operative mortality, which varied according to the malperfused region. Partial aortic arch replacement, compared with ascending aorta or hemiarch replacement alone, was not associated with increased mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.