{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T10:47:00Z","timestamp":1772534820514,"version":"3.50.1"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003To evaluate the long-term results of remodeling in acute aortic dissection type A (AADA) to define operative risk and root and valve stability.<\/jats:p><jats:p>\n          Methods\u2003Between October 1995 and December 2018, a total of 352 patients were treated surgically for AADA. Of these, 90 patients with AADA (&lt;2 weeks from onset; age: 57\u2009\u00b1\u200915 years; 70 males) with a root diameter of &gt;43 to 45\u2009mm (depending on patient size) (48\u2009\u00b1\u20094.1\u2009mm) underwent aortic root remodeling and were analyzed further. As the control group, we chose the patients with normally sized aortic roots who had been treated by tubular replacement only (n\u2009=\u2009227). Other procedures were performed in 35 cases.<\/jats:p><jats:p>\n          Results\u2003Early mortality was 9% in the remodeling group versus 15% in the tubular ascending aortic replacement (TAR). Actuarial survival at 10 and 15 years was 68\u2009\u00b1\u20095% and 58.3\u2009\u00b1\u20096.4%, respectively, in the root remodeling group versus 68\u2009\u00b1\u20094% and 66\u2009\u00b1\u20094% in the TAR group (p\u2009=\u20090.99). Freedom from reoperation on the aortic valve or root was 95\u2009\u00b1\u20093% at 10 years and at 89\u2009\u00b1\u20096% at 15 years. Freedom from proximal reoperation after TAR at 10 and 15 years was 93\u2009\u00b1\u20093% and 91\u2009\u00b1\u20093% (n\u2009=\u200931 patients at risk), respectively, not statistically different from that after remodeling (p\u2009=\u20090.75).<\/jats:p><jats:p>\n          Conclusions\u2003The long-term stability of aortic root remodeling for enlarged roots with AADA was comparable to TAR preserving a normal aortic root.<\/jats:p>","DOI":"10.1055\/s-0040-1718937","type":"journal-article","created":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T00:46:50Z","timestamp":1606870010000},"page":"329-335","source":"Crossref","is-referenced-by-count":5,"title":["Aortic Root Remodeling in Acute Aortic Dissection"],"prefix":"10.1055","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6217-5963","authenticated-orcid":false,"given":"Tristan","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irem","family":"Karliova","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennart","family":"Froede","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Giebels","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kunihara","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Joachim","family":"Sch\u00e4fers","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,12,1]]},"reference":[{"issue":"05","key":"ref1","first-page":"507","article-title":"Fate of the aortic valve after root reconstruction in type A aortic dissection: a 20-year follow up","volume":"18","author":"A Piccardo","year":"2009","journal-title":"J Heart Valve Dis"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/ejcts\/ezs342","article-title":"Acute type A aortic dissection: long-term results and reoperations","volume":"43","author":"J A Bekkers","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1016\/j.athoracsur.2007.01.006","article-title":"Midterm results of aortic repair using a fabric neomedia and fibrin glue for type A acute aortic dissection","volume":"83","author":"T Nakajima","year":"2007","journal-title":"Ann Thorac Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jtcvs.2012.08.055","article-title":"Aortic root conservative repair of acute type A aortic dissection involving the aortic root: fate of the aortic root and aortic valve function","volume":"146","author":"S K Ro","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.ejcts.2004.12.059","article-title":"Composite aortic root replacement in acute type A dissection: time to rethink the indications?","volume":"27","author":"J C Halstead","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/S0735-1097(00)00834-2","article-title":"Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial","volume":"36","author":"K Hammermeister","year":"2000","journal-title":"J Am Coll Cardiol"},{"issue":"12","key":"ref7","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1136\/hrt.2010.210286","article-title":"Surgical management of aortic root disease in Marfan syndrome: a systematic review and meta-analysis","volume":"97","author":"U Benedetto","year":"2011","journal-title":"Heart"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1016\/S0003-4975(00)01980-9","article-title":"Valve-preserving operation in acute aortic dissection type A","volume":"70","author":"T P Graeter","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"ref9","first-page":"I229","article-title":"High failure rate after valve-sparing aortic root replacement using the \u201cremodeling technique\u201d in acute type A aortic dissection","volume":"106","author":"R G Leyh","year":"2002","journal-title":"Circulation"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0003-4975(03)00262-5","article-title":"Up to 7 years' experience with valve-sparing aortic root remodeling\/reimplantation for acute type A dissection","volume":"76","author":"A W Erasmi","year":"2003","journal-title":"Ann Thorac Surg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"II243","DOI":"10.1161\/01.CIR.0000138948.14144.d6","article-title":"Evolving strategies for treatment of acute aortic dissection type A","volume":"110","author":"K Kallenbach","year":"2004","journal-title":"Circulation"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.ejcts.2006.09.018","article-title":"Should a reimplantation valve sparing procedure be done systematically in type A aortic dissection?","volume":"31","author":"F Farhat","year":"2007","journal-title":"Eur J Cardiothorac Surg"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/j.athoracsur.2012.04.094","article-title":"Valve-sparing root reconstruction does not compromise survival in acute type A aortic dissection","volume":"94","author":"S Subramanian","year":"2012","journal-title":"Ann Thorac Surg"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1093\/ejcts\/ezt042","article-title":"Valve-sparing aortic root repair in acute type A dissection: how many sinuses have to be repaired for curative surgery?","volume":"44","author":"P P Urbanski","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.athoracsur.2014.08.079","article-title":"Midterm results of David V valve-sparing aortic root replacement in acute type A aortic dissection","volume":"99","author":"B G Leshnower","year":"2015","journal-title":"Ann Thorac Surg"},{"issue":"02","key":"ref16","first-page":"116","article-title":"Is the Bentall procedure still the gold standard for acute aortic dissection with aortic root involvement?","volume":"64","author":"E Beckmann","year":"2016","journal-title":"Thorac Cardiovasc Surg"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.jtcvs.2016.03.076","article-title":"Aortic root remodeling leads to good valve stability in acute aortic dissection and preexistent root dilatation","volume":"152","author":"T Kunihara","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"07","key":"ref18","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"P Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1016\/j.jtcvs.2011.07.036","article-title":"Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair","volume":"143","author":"T Kunihara","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1016\/j.jtcvs.2012.11.059","article-title":"Early results with annular support in reconstruction of the bicuspid aortic 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Eusanio","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"02","key":"ref24","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.jtcvs.2012.01.042","article-title":"Clinical presentation, management, and short-term outcome of patients with type A acute dissection complicated by mesenteric malperfusion: observations from the International Registry of Acute Aortic Dissection","volume":"145","author":"M Di Eusanio","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"01","key":"ref25","first-page":"94","article-title":"Resuspension of the aortic valve in acute type A dissection: long-term results","volume":"17","author":"F F Immer","year":"2008","journal-title":"J Heart Valve Dis"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jtcvs.2017.09.038","article-title":"Root replacement in acute dissection type A-A superior procedure?","volume":"155","author":"H J 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