Distal anastomotic new-entry tear after type A aortic dissection repair: Incidence patterns and long-term outcomes by extent of aortic replacement

Distal anastomotic new-entry tear commonly develops at the greater curve of the aortic arch after acute type A aortic dissection repair and substantially increases the risk of distal reoperation after hemiarch replacement and partial arch replacement but not total arch replacement, suggesting that total arch replacement may protect against distal anastomotic new-entry tear-related reoperations, particularly in patients with supra-aortic branch dissection. Careful surgical planning and long-term surveillance are crucial for optimizing outcomes.