{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:44:16Z","timestamp":1770140656971,"version":"3.49.0"},"reference-count":20,"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>Sex-related disparities are well established in cardiovascular disease, but their impact on outcomes after valve-sparing root replacement (VSRR) is not well defined. In a multicentre international cohort, we evaluated sex-based differences in clinical characteristics, radiographic features and outcomes after elective VSRR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed all patients who underwent VSRR between 2004 and 2024 at 3 high-volume centres in the United States and Europe. Baseline, operative, and imaging data were compared between sexes. The primary end-point was a composite of all-cause mortality, 30-day cerebrovascular accident, and Zone 0-3 aortic reintervention or aortic valve reintervention. Kaplan-Meier and competing risk analyses were performed, with 4:1 propensity score matching (calliper 0.2) to adjust for baseline imbalances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1019 patients (191 women, 19%) undergoing VSRR were included in the study. Women were younger (46.7 vs 50.4 years, P\u2009=\u2009.002), more likely to present with heritable thoracic aortic disease (HTAD) (51% vs 17%, P\u2009&amp;lt;\u2009.001), and had smaller aortic diameters but larger indexed dimensions compared with men (all P\u2009\u2264\u2009.001). Aortic valve leaflet repair was performed less frequently in women (17% vs 34%, P\u2009&amp;lt;\u2009.001). After matching, no significant sex differences were observed in early outcomes. At 10 years, freedom from the composite end-point was similar between women and men (82.8% vs 83.9%, P\u2009=\u2009.740), as were survival (95.0% vs 96.4%, P\u2009=\u2009.920) and cumulative incidences of reintervention or dissection. Age thresholds for adverse events were lower in women (&amp;gt;50 years) than in men (&amp;gt;59 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Only one-fifth of VSRR patients were women, who presented younger with more HTAD and smaller absolute aortic diameters. Despite these differences, long-term outcomes were equivalent, suggesting that sex alone does not determine surgical results. Earlier surgical referral guided by indexed aortic measurements may improve recognition and outcomes in women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag009","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:14:50Z","timestamp":1769422490000},"source":"Crossref","is-referenced-by-count":0,"title":["Sex Disparities in Elective Valve-Sparing Root Replacement: Evidence From a Multicentre Study"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7371-6892","authenticated-orcid":false,"given":"Murat","family":"Yildiz","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]},{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , Bern 3010,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8859-8884","authenticated-orcid":false,"given":"Maria","family":"Nucera","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , Bern 3010,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Kreibich","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, Albert Ludwig\u2019s University of Freiburg , Freiburg 79106,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3576-433X","authenticated-orcid":false,"given":"Murat","family":"Uzdenov","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of 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