{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:55:53Z","timestamp":1791370553395,"version":"4.3.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The Stanford classification does not differentiate between antegrade and retrograde primary entry tears in acute Stanford type A aortic dissection (ATAAD). The 2020 Society for Vascular Surgery\/Society of Thoracic Surgeons (SVS\/STS) classification categorizes ATAAD into SVS\/STS-A and SVS\/STS-B0 based on the location of the primary entry tear; however, its clinical utility requires further validation. This study aims to evaluate the impact of the SVS\/STS-A and SVS\/STS-B0 on the prognosis and strategies for ATAAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 931 consecutive ATAAD patients at Union Hospital (Wuhan, China) from June 2012 to August 2025. According to the SVS\/STS classification criteria, patients were classified as the SVS\/STS-A (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009743) and SVS\/STS-B0 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009188) dissection. Baseline demographics, aortic anatomical features, treatment strategies, and clinical outcomes were compared between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The SVS\/STS-A patients had more severe proximal aortic pathology, while the SVS\/STS-B0 patients had more extensive distal involvement. The SVS\/STS-A group underwent more aortic root replacement (36.8% vs. 7.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), aortic valve replacement (35.7% vs. 9.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and coronary artery bypass grafting (35.1% vs. 9.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). In contrast, the SVS\/STS-B0 group underwent more total arch replacement (78.2% vs. 65.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.012) and the stented elephant trunk procedure (78.9% vs. 59.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). In the overall cohort, the SVS\/STS-A group demonstrated higher 24\u2005h mortality (9.8% vs. 1.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), in-hospital mortality (24.2% vs. 14.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004), and 3-year all-cause mortality (31.70% vs. 17.80%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0005) compared to the SVS\/STS-B0 group. In the open surgery subgroup, no significant prognostic difference existed between the two types. In the non-surgery subgroup, the SVS\/STS-A group had significantly higher 24\u2005h mortality (31.6% vs. 5.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) and in-hospital mortality (49.5% vs. 8.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SVS\/STS classification provides effective preoperative risk stratification for ATAAD. The SVS\/STS-A dissections carry a higher early mortality risk, necessitating urgent surgical intervention with aggressive management of the aortic root. In contrast, the SVS\/STS-B0 dissections allow a wider surgical window, with strategies emphasizing arch replacement and distal remodeling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1774053","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:24:47Z","timestamp":1774329887000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the society for vascular surgery\/society of thoracic surgeons classification on prognosis and therapeutic strategies in acute Stanford type A aortic dissection"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhendan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, 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Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Emergency Intensive Care Unit, Sir Run Run Shaw Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianbo","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Union Hospital, Tongji Medical College, 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