{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T09:20:45Z","timestamp":1772616045213,"version":"3.50.1"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To systematically review propensity score-matched studies comparing hybrid arch repair (HAR) with total arch replacement (TAR) for aortic arch pathologies, summarizing early outcomes and intermediate-term results.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We searched PubMed, Embase, the Cochrane Library, and Google Scholar to April 2024. The primary outcome was in-hospital mortality, evaluated by a random-effects model to calculate the odds ratio (OR). Time-to-event outcomes were synthesized as hazard ratios (HR) using inverse variance method.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Eight studies comprising 860 patients were included. There was no significant difference in in-hospital mortality between HAR and TAR groups (OR 0.66; 95% CI 0.33\u20131.31; p\u2009=\u20090.240). HAR was associated with a lower incidence of renal failure (OR 0.51; 95% CI 0.30\u20130.88; p\u2009=\u20090.020). In the isolated type A aortic dissection (ITAAD) subgroup, HAR showed a non-significant trend toward lower in-hospital mortality (OR 0.66; 95% CI 0.33\u20131.31, p\u2009=\u20090.24). In mixed degeneration-dissection (MDAD), TAR showed a non-significant trend toward lower risk of permanent neurological dysfunction (PND) (OR 2.84; 95% CI 0.89\u20139.10; p\u2009=\u20090.080) and a significantly lower three-year re-interventions rate (HR 2.99; 95% CI 1.48\u20136.04; p\u2009&lt;\u20090.001). Other postoperative complications did not differ significantly: sternal re-entry for hemorrhage (OR 0.55; 95% CI 0.21\u20131.43; p\u2009=\u20090.220), and tracheostomy (OR 1.08; 95% CI 0.43\u20132.72; p\u2009=\u20090.870).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>HAR was associated with a lower risk of renal failure. In ITAAD, HAR showed a trend toward lower in-hospital mortality, whereas in MDAD cohorts, TAR showed a significantly lower three-year re-intervention rate. These findings should be interpreted with caution given the small number of studies and underlying heterogeneity. Further observational studies or randomized trials are warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0314341","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:27:57Z","timestamp":1757006877000},"page":"e0314341","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of early and intermediate-term outcomes between hybrid arch debranching and total arch replacement: A systematic review and meta-analysis of propensity-matched 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