{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T09:10:18Z","timestamp":1781428218531,"version":"3.54.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Our aim was to evaluate the risk of concomitant aortic root replacement during frozen elephant trunk (FET) total arch replacement.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Between March 2013 and February 2021, 303 patients underwent aortic arch replacement using the FET technique. Patient characteristics, intra- and postoperative data were compared between patients with (n\u2009=\u200950) and without (n\u2009=\u2009253) concomitant aortic root replacement (implantation of a valved conduit or using the reimplantation valve-sparing technique) after propensity score matching.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>After propensity score matching, there were no statistically significant differences in preoperative characteristics including the underlying pathology. There was no statistically significant difference regarding arterial inflow-cannulation or concomitant cardiac procedures, while cardiopulmonary bypass (P\u2009&amp;lt;\u20090.001) and aortic cross-clamp (P\u2009&amp;lt;\u20090.001) times were significantly longer in the root replacement group. Postoperative outcome was similar between the groups and there were no proximal reoperations in the root replacement group during follow-up. Root replacement was not predictive for mortality (P\u2009=\u20090.133, odds ratio: 0.291) in our Cox regression model. There was no statistically significant difference in overall survival (log rank: P\u2009=\u20090.062).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Concomitant FET implantation and aortic root replacement prolongs operative times but does not influence postoperative outcomes or increase operative risk in an experienced high-volume centre. The FET procedure did not appear to be a contraindication for concomitant aortic root replacement even in patients with borderline indications for aortic root replacement.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezad053","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T13:53:30Z","timestamp":1676901210000},"source":"Crossref","is-referenced-by-count":10,"title":["Concomitant aortic root replacement during frozen elephant trunk implantation does not increase perioperative risk"],"prefix":"10.1093","volume":"63","author":[{"given":"Tim","family":"Berger","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg , Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salome","family":"Chikvatia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg , Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3305-9343","authenticated-orcid":false,"given":"Matthias","family":"Siepe","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Bern, University of Bern , Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stoyan","family":"Kondov","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg , Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Meissl","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg , Freiburg, 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