{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:09:32Z","timestamp":1782263372973,"version":"3.54.5"},"reference-count":21,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jtcvsonline.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Thoracic and Cardiovascular Surgery"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.jtcvs.2025.11.005","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:38:21Z","timestamp":1762958301000},"page":"1177-1185.e6","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intention-to-treat outcome analysis for valve-sparing aortic root replacement: Is there a price to pay for failure?"],"prefix":"10.1016","volume":"171","author":[{"given":"Ghazal","family":"Sanadgol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruby","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Kirby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adham","family":"Makarem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Odekunle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thoralf M.","family":"Sundt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan P.","family":"Bloom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Isselbacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serguei","family":"Melnitchouk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Kreso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motahar","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5412-3506","authenticated-orcid":false,"given":"Arminder","family":"Jassar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"4","key":"10.1016\/j.jtcvs.2025.11.005_bib1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0022-5223(19)34942-6","article-title":"An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta","volume":"103","author":"David","year":"1992","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2025.11.005_bib2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s12055-023-01587-4","article-title":"Aortic valve-sparing operations: my perspectives","volume":"39","author":"Perri","year":"2023","journal-title":"Indian J Thorac Cardiovasc Surg"},{"issue":"3","key":"10.1016\/j.jtcvs.2025.11.005_bib3","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/j.jtcvs.2014.04.048","article-title":"A quarter of a century of experience with aortic valve-sparing operations","volume":"148","author":"David","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"1","key":"10.1016\/j.jtcvs.2025.11.005_bib4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jtcvs.2012.09.013","article-title":"David valve-sparing aortic root replacement: equivalent mid-term outcome for different valve types with or without connective tissue disorder","volume":"145","author":"Kvitting","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"1","key":"10.1016\/j.jtcvs.2025.11.005_bib5","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jtcvs.2018.10.155","article-title":"Long-term experience with valve-sparing reimplantation technique for the treatment of aortic aneurysm and aortic regurgitation","volume":"158","author":"Mastrobuoni","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"1","key":"10.1016\/j.jtcvs.2025.11.005_bib6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jtcvs.2018.10.151","article-title":"Valve-sparing root replacement in patients with bicuspid versus tricuspid aortic valves","volume":"158","author":"Ouzounian","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"13","key":"10.1016\/j.jtcvs.2025.11.005_bib7","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1016\/j.jacc.2015.07.041","article-title":"Outcomes of aortic valve-sparing operations in Marfan syndrome","volume":"66","author":"David","year":"2015","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"10.1016\/j.jtcvs.2025.11.005_bib8","doi-asserted-by":"crossref","first-page":"433","DOI":"10.21037\/acs-2021-rp-24","article-title":"The Ross procedure and valve-sparing root replacement procedures in the adult patient: do guidelines follow the evidence?","volume":"10","author":"Vervoort","year":"2021","journal-title":"Ann Cardiothorac Surg"},{"issue":"23","key":"10.1016\/j.jtcvs.2025.11.005_bib9","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1136\/heartjnl-2022-320870","article-title":"Early and long-term outcomes of conventional and valve-sparing aortic root replacement","volume":"108","author":"Jahangiri","year":"2022","journal-title":"Heart"},{"issue":"4","key":"10.1016\/j.jtcvs.2025.11.005_bib10","first-page":"524","article-title":"Comparison of the Bentall procedure versus valve-sparing aortic root replacement","volume":"33","author":"Hamandi","year":"2020","journal-title":"Proc (Bayl Univ Med Cent)"},{"issue":"3","key":"10.1016\/j.jtcvs.2025.11.005_bib11","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.amjsurg.2023.07.004","article-title":"Long-term outcomes of valve-sparing aortic root versus composite aortic valve graft replacement for aortic root aneurysm: meta-analysis of reconstructed time-to-event data","volume":"226","author":"S\u00e1","year":"2023","journal-title":"Am J Surg"},{"issue":"1","key":"10.1016\/j.jtcvs.2025.11.005_bib12","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.athoracsur.2019.11.054","article-title":"Valve-sparing root replacement versus composite valve grafting in aortic root dilation: a meta-analysis","volume":"110","author":"Elbatarny","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2025.11.005_bib13","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijcard.2024.132728","article-title":"Long-term outcomes comparison of Bentall-De Bono-versus valve-sparing aortic root replacement: an updated systematic review and reconstructed time-to-event meta-analysis","volume":"419","author":"Formica","year":"2025","journal-title":"Int J Cardiol"},{"issue":"6","key":"10.1016\/j.jtcvs.2025.11.005_bib14","first-page":"684","article-title":"Intraoperative conversion in root replacement intraoperative conversion after surgical failure an overlooked complication of aortic root replacement in Marfan patients?","volume":"38","author":"Volguina","year":"2011","journal-title":"Tex Heart Inst J"},{"issue":"suppl 1","key":"10.1016\/j.jtcvs.2025.11.005_bib15","first-page":"S120","article-title":"Effects of preoperative aortic insufficiency on outcome after aortic valve-sparing surgery","volume":"120","author":"De Kerchove","year":"2009","journal-title":"Circulation"},{"key":"10.1016\/j.jtcvs.2025.11.005_bib16","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.athoracsur.2016.04.061","article-title":"Impact of cusp repair on reoperation risk after the David procedure","volume":"102","author":"Settepani","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2025.11.005_bib17","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.athoracsur.2016.07.004","article-title":"Severity of preoperative aortic regurgitation does not impact valve durability of aortic valve repair following the David V valve sparing aortic root replacement","volume":"103","author":"Keeling","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2025.11.005_bib18","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.athoracsur.2017.09.029","article-title":"Sixteen-year experience of David and Bentall procedures in acute type A aortic dissection","volume":"105","author":"Yang","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2025.11.005_bib19","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.athoracsur.2016.01.094","article-title":"Complex cusp repair in patients undergoing the david procedure: is it worth it?","volume":"102","author":"Baumbach","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2025.11.005_bib20","first-page":"661","article-title":"Valve-sparing root replacement: where are the limits?","volume":"38","author":"Badiu","year":"2011","journal-title":"Tex Heart Inst J"},{"issue":"3","key":"10.1016\/j.jtcvs.2025.11.005_bib21","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.cjco.2023.11.022","article-title":"Valve-sparing root replacement: reimplantation technique","volume":"6","author":"Qiu","year":"2024","journal-title":"CJC Open"}],"container-title":["The Journal of Thoracic and Cardiovascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022522325009766?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022522325009766?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:16:27Z","timestamp":1780294587000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022522325009766"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S0022522325009766"],"URL":"https:\/\/doi.org\/10.1016\/j.jtcvs.2025.11.005","relation":{},"ISSN":["0022-5223"],"issn-type":[{"value":"0022-5223","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Intention-to-treat outcome analysis for valve-sparing aortic root replacement: Is there a price to pay for failure?","name":"articletitle","label":"Article Title"},{"value":"The Journal of Thoracic and Cardiovascular Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jtcvs.2025.11.005","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 by The American Association for Thoracic Surgery","name":"copyright","label":"Copyright"}]}}