Follow-up and Study Endpoints

Patients were discharged (with oral medications to maintain systolic blood pressure [< 120 mmHg]) after receiving necessary open surgery or until the complete absorption of the ascending aortic hematoma with or without necessary TEVAR. The surveillance included clinical examinations and imaging re-examinations at 1, 3, 6, and 12 months and then annually. All imaging studies were independently evaluated by one radiologist (F.Y.) and two cardiac surgeons (Q. C. and F.K.) who specialized in cardiac imaging techniques. The criteria for further reintervention were as follows: complications after TEVAR (endo-leak, ascending aortic pseudoaneurysm retrograding, retrograde type A aortic dissection), signs of aortic rupture, rapid growth of aortic diameters (>5 mm/year), or a maximum aorta diameter > 55 mm [10][16] . The primary outcome was aorta-related mortality (confirmed by autopsy or CTA examination). Secondary outcomes included all-cause mortality and aortic remodeling.