{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:48:03Z","timestamp":1753890483894,"version":"3.41.2"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To compare outcomes between sinus replacement (SR) and conservative repair (CR) for dissected roots with normal size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From October 2018 to April 2021, a prospective cohort study was carried out. Patients were assigned to two groups (SR group and CR group) according to whether they underwent sinus replacement. Propensity score matching was applied to adjust preoperative variables and Kaplan\u2013Meier method was used for survival analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred and eighty-seven patients were enrolled. In the whole cohort, 18 patients (4.7%) died postoperatively. The operative mortality of SR group was comparable to CR group (3.2% vs. 6.0%, <jats:italic>p<\/jats:italic> = 0.192 before matching; 3.5% vs. 7.0%, <jats:italic>p<\/jats:italic> = 0.267 after matching) and the incidence of hemostasis management under restarted cardiopulmonary bypass for root bleeding was lower in SR group (1.6% vs. 7.0%, <jats:italic>p<\/jats:italic> = 0.002 before matching; 2.1% vs. 8.5%, <jats:italic>p<\/jats:italic> = 0.03 after matching). The median follow-up duration was 12 months. There were 3 reoperations in the CR group. The estimated cumulative event rate of reoperation was 1.1 % at 12 months and 1.6% at 24 months in CR group, with a trend of a lower rate in the SR group (log-rank <jats:italic>p<\/jats:italic> = 0.089 before matching, <jats:italic>p<\/jats:italic> = 0.075 after matching). There was one late death in each group. The estimated cumulative event rate of death was 3.8% at 12 months and 24 months in the SR group, and was 6.6% in the CR group with no significant difference (log-rank <jats:italic>p<\/jats:italic> = 0.218 before matching, <jats:italic>p<\/jats:italic> = 0.120 after matching). Aortic regurgitation significantly improved postoperatively and remained stable during follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sinus replacement is a simple, safe, and effective technique for repairing severely dissected sinus with a comparable time spent in operation and excellent immediate and short-term results. It had the advantages of eliminating false lumen and avoiding aortic root bleeding.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.880411","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T05:04:40Z","timestamp":1652936680000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative and Short-Term Outcomes of Sinus Replacement and Conservative Repair for Aortic Root in Acute Type A Aortic Dissection: A Prospective Cohort Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Yi","family":"Chang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangyang","family":"Qian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongwei","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yizhen","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuntao","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaogang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiong","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e266","DOI":"10.1161\/CIR.0b013e3181d4739e","article-title":"2010 ACCF\/AHA\/AATS\/ACR\/ASA\/SCA\/SCAI\/SIR\/STS\/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine","volume":"121","author":"Hiratzka","year":"2010","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"784e9","DOI":"10.1016\/j.jtcvs.2009.11.014","article-title":"Role of age in acute type A aortic dissection outcome: report from the International Registry of Acute Aortic Dissection (IRAD)","volume":"140","author":"Trimarchi","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.athoracsur.2005.02.059","article-title":"Long-term results after 27 years of surgical treatment of acute type a aortic dissection","volume":"80","author":"Tan","year":"2005","journal-title":"Ann Thorac Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/j.athoracsur.2011.10.059","article-title":"Dell'Aquila A, Musumeci F. Reoperation after surgical correction of acute type A aortic dissection: risk factor analysis","volume":"93","author":"Concistr\u00e8","year":"2012","journal-title":"Ann Thorac Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1067\/mtc.2002.119702","article-title":"Risk factor analysis for proximal and distal reoperations after surgery for acute type A aortic dissection","volume":"123","author":"Kirsch","year":"2002","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1093\/icvts\/ivw002","article-title":"Acute aortic dissection involving the root: operative and long-term outcome after curative proximal repair","volume":"22","author":"Urbanski","year":"2016","journal-title":"Interact CardioVasc Thorac Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1093\/ejcts\/ezs371","article-title":"modified valve-sparing aortic root replacement technique for acute type A aortic dissection: the patch neointima technique","volume":"42","author":"Chen","year":"2012","journal-title":"Eur J Cardiothorac Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1067\/mtc.2001.112534","article-title":"Proximal aortic dissection with coronary malperfusion: presentation, management, and outcome","volume":"121","author":"Neri","year":"2001","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1016\/j.athoracsur.2014.04.050","article-title":"Long-term results of neomedia sinus valsalva repair in 489 patients with type A aortic dissection","volume":"98","author":"Rylski","year":"2014","journal-title":"Ann Thorac Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1016\/j.ejcts.2005.08.029","article-title":"Adventitial inversion technique without the aid of biologic glue or Teflon buttress for acute type A aortic dissection","volume":"28","author":"Tanaka","year":"2005","journal-title":"Eur J Cardiothorac Surg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1093\/ejcts\/ezaa156","article-title":"Prediction of mortality rate in acute type A dissection: the German Registry for Acute Type A Aortic Dissection score","volume":"58","author":"Czerny","year":"2020","journal-title":"Eur J Cardiothorac Surg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.4103\/0366-6999.179797","article-title":"Surgical treatment of coronary malperfusion with acute type A aortic dissection","volume":"129","author":"Tang","year":"2016","journal-title":"Chin Med J."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1016\/j.athoracsur.2018.09.065","article-title":"Management of patients with coronary artery malperfusion secondary to type A aortic dissection","volume":"107","author":"Kreibich","year":"2019","journal-title":"Ann Thorac Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1016\/j.jtcvs.2019.04.036","article-title":"Long-term outcomes after valve-sparing anatomical aortic root reconstruction in acute dissection involving the root","volume":"159","author":"Irimie","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1016\/0003-4975(93)91100-2","article-title":"Preservation of the aortic valve in acute aortic dissection: long-term echocardiographic assessment and clinical outcome","volume":"55","author":"Mazzucotelli","year":"1993","journal-title":"Ann Thorac Surg."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1016\/j.jtcvs.2012.08.055","article-title":"Aortic root conservative repair of acute type A aortic dissection involving the aortic root: Fate of the aortic root and aortic valve function","volume":"146","author":"Ro","year":"2013","journal-title":"J Thorac Cardiovasc Surg."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.880411\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T05:04:59Z","timestamp":1652936699000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.880411\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,19]]},"references-count":16,"alternative-id":["10.3389\/fcvm.2022.880411"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.880411","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2022,5,19]]},"article-number":"880411"}}