{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:47:48Z","timestamp":1777985268214,"version":"3.51.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T00:00:00Z","timestamp":1608940800000},"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":[[2021,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>\u2002<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>We evaluated the long-term results of aortic root (AR) preservation and replacement in patients operated on for acute type A aortic dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Out of 302 patients discharged after repair of acute aortic dissection (1977\u20132019), 124 patients had an AR \u226540 mm, which was preserved in 84 (68%, group A) patients and replaced in 40 (32%, group B) patients. Group B patients were younger (mean age 57\u2009\u00b1\u200912 vs 62\u2009\u00b1\u200911\u2009years, P\u2009=\u20090.07), with a mean AR of 47 vs 43\u2009mm and \u2265moderate aortic insufficiency in 65% vs 30%. Survival, causes of death and reoperations were analysed at mean follow-up of 9\u2009\u00b1\u20098\u2009years (6\u2009months to 40\u2009years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Actuarial survival of discharged patients at 5, 10 and 15\u2009years was 97% (0.89\u20130.99), 78% (0.67\u20130.90) and 75% (0.64\u20130.88) in group A, and 85% (0.71\u20130.95), 62% (0.44\u20130.78) and 57% (0.39\u20130.76) in group B (log-rank test P\u2009=\u20090.2). Nine patients in group A (7 patients for aortic insufficiency and dilatation of the root and 2 patients for pseudoaneurysm) and 1 patient of group B (pseudoaneurysm of the right coronary button) required proximal reoperation without deaths. At 5, 10 and 15\u2009years, the cumulative incidence of proximal aortic reoperations was 5%, 9% and 25% in group A, and 0%, 3% and 3% in group B (P\u2009=\u20090.02). At multivariable analysis AR &amp;gt;45 mm [hazard ratio (HR) 6.8, P\u2009=\u20090.026] and age (HR 0.9, P\u2009=\u20090.016) were independently associated with proximal reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>AR preservation in acute type A dissection showed acceptable long-term outcomes. Nevertheless, a more aggressive approach appears a valid option, especially in patients with AR diameter &amp;gt;45\u2009mm.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa456","type":"journal-article","created":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T07:07:06Z","timestamp":1606028826000},"page":"1115-1122","source":"Crossref","is-referenced-by-count":21,"title":["Type A acute aortic dissection with \u226540-mm aortic root: results of conservative and replacement strategies at long-term follow-up"],"prefix":"10.1093","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3473-1779","authenticated-orcid":false,"given":"Igor","family":"Vendramin","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Cardiothoracic Department, University Hospital of Udine, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Lechiancole","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiothoracic Department, University Hospital of Udine, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9959-167X","authenticated-orcid":false,"given":"Daniela","family":"Piani","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiothoracic Department, University Hospital of Udine, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Deroma","sequence":"additional","affiliation":[{"name":"Health Management Department, University Hospital of Udine, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annarita","family":"Tullio","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandro","family":"Sponga","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiothoracic Department, University Hospital of Udine, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo D","family":"Milano","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Emergencies and organ transplantation, University of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0879-3557","authenticated-orcid":false,"given":"Francesco","family":"Onorati","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona Medical School, Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uberto","family":"Bortolotti","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardiothoracic Department, University Hospital of Udine, Udine, 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