{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:58:36Z","timestamp":1785772716171,"version":"3.56.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Seoul National University Hospital Research Fund","award":["04-2022-2240"],"award-info":[{"award-number":["04-2022-2240"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate contemporary outcomes of elective ascending aortic replacement (AAR) and the impact of centre volume using a nationwide database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults undergoing elective AAR for aneurysms (2003-2021) were identified from the Korean National Health Insurance Service database. Acute dissections, ruptures, and arch involvements were excluded. Restricted cubic splines (RCS) and multivariable regression evaluated the impact of institutional volume and concomitant procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5209 patients, operative mortality and stroke rates were 2.9% and 2.2%. Over a 5.9-year median follow-up, RCS revealed a significant non-linear inverse relationship between annual institutional volume and mortality. Treatment at high-volume centres (\u226510 cases\/year) independently lowered operative mortality (odds ratio, 0.26; 95% CI, 0.18-0.37) and long-term mortality (hazard ratio, 0.64; 95% CI, 0.57-0.73). Distinct clinical phenotypes, including bicuspid aortic valves and concomitant aortic valve surgery, were associated with favourable survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elective AAR demonstrates low perioperative risk and stable long-term survival, significantly influenced by annual institutional volume and clinical phenotypes. These findings support dedicated aortic centres and individualized risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag184","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:25:44Z","timestamp":1785151544000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of Ascending Aortic Replacement for Aneurysm and the Impact of Centre Volume: A Nationwide Population-Based Study"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-5232","authenticated-orcid":false,"given":"Sue Hyun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Critical Care, Seoul National University Hospital , Seoul 03080,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhee","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institute, Seoul National University Hospital , Seoul 03080,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2528-173X","authenticated-orcid":false,"given":"Yoonjin","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine , Seoul 03080,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7391-3415","authenticated-orcid":false,"given":"Suk Ho","family":"Sohn","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine , Seoul 03080,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3342-1381","authenticated-orcid":false,"given":"Yeiwon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Seoul National University Hospital , Seoul 03080,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-8118","authenticated-orcid":false,"given":"Ho Young","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine , Seoul 03080,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2718-8758","authenticated-orcid":false,"given":"Kyung Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, 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