{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:17:09Z","timestamp":1777576629078,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The optimal extent of aortic arch intervention for acute type A aortic dissection (ATAAD) remains uncertain. Total arch replacement with a frozen elephant trunk (TAR\u2009+\u2009FET) prolongs circulatory-arrest time, whereas hybrid arch repair (HAR)\u2014supra-aortic debranching in combination with antegrade endovascular stent grafting\u2014reduces ischemic time but may increase the risk of late reintervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to compare mid-term survival and freedom from reintervention after HAR versus TAR in ATAAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, and Scopus were searched from their inception to May 2025. Kaplan\u2013Meier Curves were digitized, and individual-participant data were reconstructed with a validated algorithm. Pooled hazard ratios (HR) were derived from a one-stage flexible parametric model; robustness was assessed with two-stage random-effects meta-analysis, leave-one-out tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five propensity-matched studies (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009697; 338 HAR, 359 TAR) met inclusion criteria. Hybrid arch repair shortened cardiopulmonary bypass and avoided circulatory arrest time. Five-year survival was 86.5% for HAR versus 76.2% for TAR (log-rank\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Hybrid arch repair provided a significant early-to-mid-term survival advantage over TAR in ATAAD (HR 0.46 (95% CI 0.31\u20130.69;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001)), corresponding to about 6 months of survival benefit at 5 years. Hybrid arch repair was associated with greater likelihood of early reintervention (HR 4.07, 95% CI 0.55\u201330.34).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hybrid arch repair offers a significant early-to-mid-term survival advantage over TAR in ATAAD. In patients requiring aortic arch replacement, HAR may be favored over TAR\/FET, while extensive TAR\/FET procedures are reserved for anatomically unsuitable cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02184923251394904","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T17:09:12Z","timestamp":1763140152000},"page":"5-18","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Survival outcomes of hybrid versus total arch replacement in type A aortic dissection: A meta-analysis of reconstructed individual participant data"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2035-5631","authenticated-orcid":false,"given":"Naritsaret","family":"Kaewboonlert","sequence":"first","affiliation":[{"name":"Institute of Medicine, Suranaree University of Technology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natthipong","family":"Pongsuwan","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Suranaree University of Technology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chanut","family":"Chatkaewpaisal","sequence":"additional","affiliation":[{"name":"Bangkok Hospital Ratchasima"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiraphon","family":"Poontananggul","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Suranaree University of Technology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.01.015"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu185"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-23-1137"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.optechstcvs.2021.12.004"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.11.044"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13206248"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/15266028040110S609"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezad426"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001106"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_3_12_2","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.5","author":"Higgins J","year":"2024","unstructured":"Higgins J, Thomas J, Chandler J, et al. 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