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Hong et al. Vessel Plus 2022;6:4 https://dx.doi.org/10.20517/2574-1209.2021.88 Page 15 of 17

[19]
reported 94% freedom from reoperation of the repaired distal aorta at 20 years, and Coselli et al. reported
[37]
96% freedom from reoperation of the repaired distal aorta at 7 years. In addition, Estrera et al. reported
82% freedom from progressive aortic repair at 20 years and 85% freedom at 7 years.

Open repair of thoracoabdominal aortic aneurysms precipitated by chronic dissection remains the gold
standard, having exhibited favorable outcomes and durability. Nonetheless, patients with chronic dissection
require a rigorous lifelong surveillance protocol, as there is a significant risk for subsequent intervention on
any unrepaired aortic segments.

DECLARATIONS
Acknowledgments
The authors thank Scott A. Weldon, MA, CMI, FAMI, of the Michael E. DeBakey Department of Surgery at
Baylor College of Medicine, for creating several of the illustrations. We thank Jeanie F. Woodruff, BS, ELS,
of the Department of Scientific Publications at the Texas Heart Institute, and Susan Y. Green, MPH, of the
Michael E. DeBakey Department of Surgery at Baylor College of Medicine, for providing editorial support.
All images are used with permission of Baylor College of Medicine.

Authors’ contributions
Made substantial contributions to the conception or design of the work, or the acquisition, analysis, or
interpretation of data for the work: Hong JC, Coselli JS
Drafted the work or revised it critically for important intellectual content: Hong JC, Coselli JS
Gave final approval of the version to be published: Hong JC, Coselli JS
Agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or
integrity of any part of the work are appropriately investigated and resolved: Hong JC, Coselli JS

Availability of data and materials
Not applicable.

Financial support and sponsorship
Dr. Coselli’s work is partly supported by the Cullen Foundation.

Conflicts of interest
Dr. Coselli consults for, receives royalties and a departmental educational grant from, and participates in
clinical trials for Terumo Aortic; consults and participates in clinical trials for Medtronic, Inc., and W. L.
Gore & Associates; and serves as a co-investigator for CytoSorbents. Dr. Hong has no disclosures.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2022.

REFERENCES
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2. Zafar MA, Chen JF, Wu J, et al; Yale Aortic Institute Natural History Investigators. Natural history of descending thoracic and
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