Evidence map›Paper›PMID 40397142›Full record

ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2025

Distal anastomotic new entry tears predict long-term outcomes after hemi-arch repair for DeBakey I aortic dissection†.

Prabhvir S Marway, Carlos A Campello Jorge, Rana-Armaghan Ahmad, Nicasius Tjahjadi, Himanshu J Patel, Bo Yang, Nicholas S Burris

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Prabhvir S MarwayDepartment of Radiology, University of Michigan, Ann Arbor, MI, USA.ORCID 0000-0002-5768-4859
Carlos A Campello JorgeDepartment of Radiology, University of Michigan, Ann Arbor, MI, USA.
Rana-Armaghan AhmadDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
Nicasius TjahjadiDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
Himanshu J PatelDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.ORCID 0000-0001-7639-2416
Bo YangDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
Nicholas S BurrisDepartment of Radiology, University of Michigan, Ann Arbor, MI, USA.ORCID 0000-0002-5198-4383

Funding

Non-invasive hemodynamic and biomechanic imaging methods for early risk prediction in aortic dissectionR01HL170059 · NHLBI · UNIVERSITY OF WISCONSIN-MADISON · PI Nicholas Scott Burris, David Alexander Nordsletten · 2023 to 2026
$2.4M
Vascular Deformation Mapping (VDM) for Automated, 3D Assessment of Thoracic Aortic AneurysmR44HL145953 · NHLBI · IMBIO, LLC · PI BURRIS, NICHOLAS SCOTT, HATT, CHARLES R · 2019 to 2022
$1.5M
NHLBI NIH HHS R01 HL170059NHLBI NIH HHS R44 HL145953NIH HHSNIH HHS R01HL170059NIH HHS R44HL145953
6 · The paper itself

Abstract

objectivesAortic arch tears, including distal anastomosis new entry tears and residual arch tears, have been associated with adverse outcomes (false lumen growth, distal reoperation) after hemi-arch repair for DeBakey Type I aortic dissection. However, no study has compared distal anastomosis new entry tears and RATs as independent entities despite their distinct aetiologies and preventative strategies which may inform surgical management.

methodsRetrospective cohort study of adult patients with hemi-arch repair for DeBakey Type I aortic dissection at a tertiary referral centre (1996-2021). We included patients who survived beyond their initial hospitalization with good-quality post-operative CT angiograms. Distal anastomosis new entry tears and residual arch tears metrics were collected from the first good-quality post-operative CT. Maximal aortic diameters (distal to graft) were collected from pre- and post-hemi-arch repair CT angiograms. Presence and imaging characteristics of distal anastomosis new entry tears and RATs were examined for prediction of false lumen growth and distal aortic intervention.

resultsWe included 272 patients, and 24.5% (69) had distal anastomosis new entry tears, which on multivariable analysis was associated with a post-operative descending diameter change of +6.2 mm (95% confidence interval [CI]: 4.5, 7.9) and greater risk of distal intervention, hazard ratio 3.24 (95% CI: 1.57, 6.68); residual arch tears were not significantly associated, hazard ratio 0.72 (95% CI: 0.28, 1.83). Distal anastomosis new entry tears located on the greater curvature versus lesser curvature (58% vs 42%, P = 0.044) were more likely to lead to reoperation (45% vs 17%, P = 0.033).

conclusionsDistal anastomosis new entry tears, not residual arch tears, correlate strongly with negative descending aorta remodelling and distal intervention after hemi-arch repair for DeBakey I aortic dissection. Therefore, additional strategies are warranted to prevent distal anastomosis new entry tears, a result of anastomotic technical challenge, during operative repair.

Indexed as

Aorta, ThoracicAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationAdultAgedAnastomosis, SurgicalComputed Tomography AngiographyFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeAortic dissectionComputed tomography angiographyDistal anastomotic new entry tearFalse lumen remodelingHemi-arch repairResidual arch tear

Identifiers

PMID40397142
PMCPMC12133680

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.