{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:51:26Z","timestamp":1789102286755,"version":"build-2803163510"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"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":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare 3 surgical procedures (ascending aortic replacement [AAR], total arch replacement with conventional elephant trunk [cET], or frozen elephant trunk [FET]) for acute type A aortic dissection (ATAAD). Additionally, the AAR group was stratified by the presence or absence of arch vessel dissection (AVD), and outcomes were evaluated among the 4 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent AAR or total arch replacement with cET or FET for DeBakey type I ATAAD between December 2006 to December 2024 at 5 institutions were included. The cumulative incidence of aortic events, defined as aortic enlargement, aortic reintervention, or aorta-related adverse events, was compared between procedures using pairwise comparisons adjusted by inverse probability of treatment weighting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the total 334 patients, 136 with AAR, 94 with cET, and 104 with FET were enrolled. The 5-year cumulative incidence of aortic events was lower for FET compared with that for cET and AAR (AAR: 57.7% vs cET: 49.1% vs FET: 25.2%). Further stratification of the AAR group revealed worse outcomes for AAR with AVD (hazard ratio, 2.25; 95% confidence interval, 1.28-3.95; P\u2009=\u2009.005). FET showed superior outcomes compared with all other groups, including AAR without AVD (hazard ratio, 0.25; 95% confidence interval, 0.09-0.67; P\u2009=\u2009.006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FET for ATAAD was associated with a lower incidence of aortic events compared with other procedures. FET may be a beneficial option for ATAAD with AVD, which is associated with a higher incidence of aortic events after AAR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf419","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T12:53:43Z","timestamp":1763211223000},"source":"Crossref","is-referenced-by-count":1,"title":["Comparison of 3 Surgical Procedures for DeBakey Type I Acute Aortic Dissection: When Is Frozen Elephant Trunk Recommended?"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7060-6444","authenticated-orcid":false,"given":"Hiroshi","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Otaru General Hospital , Otaru,","place":["Japan"]},{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3832-5703","authenticated-orcid":false,"given":"Yutaka","family":"Iba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuma","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Central Hospital , Sapporo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Central Hospital , Sapporo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitaro","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo City General Hospital , Sapporo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itaru","family":"Hosaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sunagawa City Medical Center , Sunagawa,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Iwashiro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Otaru General Hospital , Otaru,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Yonemori","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Arihara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyunji","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido 060-8543,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyoshi","family":"Kawaharada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Otaru General Hospital , Otaru,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoji","family":"Fukada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Otaru General 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