{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T16:28:56Z","timestamp":1773764936742,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T00:00:00Z","timestamp":1584489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Valve repair for aortic insufficiency (AI) requires a tailored surgical approach determined by the leaflet and aortic disease. In this study, we used a repair-oriented system for the classification of AI, and we elucidated long-term outcomes of aortic root reimplantation with this classification system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>From 1999 to 2018, a total of 197 patients underwent elective reimplantation (mean age: 52.7\u2009\u00b1\u200917.7\u2009years; 80% male). The aortic valve was tricuspid in 143 patients, bicuspid in 51 patients and quadricuspid in 3 patients. A total of 93 patients had type I AI (aortic dilatation), 57 patients had type II AI (cusp prolapse) and 47 patients had type III AI (restrictive). In total, 104 of the 264 patients (39%) had more than 1 identified mechanism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In-hospital mortality was 0.5% (1\/197). Mid-term follow-up (mean follow-up duration: 5.5\u2009years) revealed a late mortality rate of 4.2% (9\/197). Aortic valve reoperation was performed on 16 patients (8.0%). Rates of freedom from aortic valve replacement and freedom from aortic valve-related events at 10\u2009years of follow-up were 87.0\u2009\u00b1\u20094.0% and 60.6\u2009\u00b1\u20096.0%, respectively; patients with type Ib AI (98.3\u2009\u00b1\u20091.7%; 80.7\u2009\u00b1\u20097.5%) had better outcomes than patients with type III AI (59.6\u2009\u00b1\u200915.6%; 42.2\u2009\u00b1\u200913.1%, P\u2009=\u20090.01). In patients with types II and III AI who had bicuspid aortic valves, rates of freedom from aortic valve-related events at 5\u2009years of follow-up were 95.2\u2009\u00b1\u20094.7% and 71.7\u2009\u00b1\u20099.1%, respectively (P\u2009=\u20090.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This repair-oriented system for classifying AI could help to predict the durable aortic valve repair techniques. Patient selection according to the classification is particularly important for long-term durability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trial registration number<\/jats:title>\n                  <jats:p>B190050.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa058","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T12:12:27Z","timestamp":1581941547000},"page":"138-144","source":"Crossref","is-referenced-by-count":6,"title":["Mid-term outcomes of valve-sparing root reimplantation with leaflet repair"],"prefix":"10.1093","volume":"58","author":[{"given":"Koki","family":"Yokawa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soichiro","family":"Henmi","sequence":"first","affiliation":[{"name":"Department of 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