{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T21:56:39Z","timestamp":1788990999654,"version":"build-2803163510"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of this study was to compare perioperative and long-term outcomes of hemiarch versus zone 2 arch replacement for DeBakey type I acute aortic dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 2002 to 2023, 743 patients underwent surgical repair for DeBakey type I acute aortic dissection with either hemiarch (N\u2009=\u2009605, 81.4%) or zone 2 arch replacement (N\u2009=\u2009138, 18.6%). 4:1 propensity-score matching yielded a cohort of 437 hemiarch patients (76.1%) and 137 zone 2 patients (23.9%). Key outcomes included 30-day mortality, 10-year survival, and distal reintervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the matched cohort, 30-day mortality was 11.9% for hemiarch and 8.0% for zone 2 arch replacement (P\u2009=\u2009.198). On multivariable analysis, zone 2 arch replacement was not associated with increased risk of 30-day mortality. Ten-year survival was similar between groups, at 56.2% (50.6%-62.6%) in the hemiarch group and 59.8% (46.4%-77.1%) in the zone 2 group. Distal reintervention was more common after zone 2 arch replacement (46.7% vs 15.8%), though the majority of reinterventions in the zone 2 group were thoracic endovascular aortic repair procedures (95.3%). In contrast, over half (53.6%) of distal reinterventions after hemiarch repair were open procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Zone 2 arch replacement resulted in comparable early and late survival to hemiarch replacement. Although distal reinterventions were more common after zone 2 arch replacement, these were predominantly low-risk thoracic endovascular aortic repair procedures. In appropriately selected patients, zone 2 arch replacement may enable more complete aortic repair without added perioperative risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag006","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T12:34:59Z","timestamp":1768048499000},"source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of Hemiarch Versus Zone 2 Arch Replacement for DeBakey Type I Aortic Dissection"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9690-3137","authenticated-orcid":false,"given":"John J","family":"Kelly","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania , Philadelphia, PA, 19104,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1720-3504","authenticated-orcid":false,"given":"Lauren 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