{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T07:54:49Z","timestamp":1775375689203,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019018","name":"CAMS Initiative for Innovative Medicine","doi-asserted-by":"publisher","award":["2016-I2M-1-016"],"award-info":[{"award-number":["2016-I2M-1-016"]}],"id":[{"id":"10.13039\/501100019018","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Special Subject Development Foundation of Fuwai Hospital","award":["NO.2015-FWTS01"],"award-info":[{"award-number":["NO.2015-FWTS01"]}]},{"name":"Beijing Science and Technology Program","award":["NO. Z191100007619042"],"award-info":[{"award-number":["NO. Z191100007619042"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Due to better postoperative convalescence and quality of life, experienced centers focus on minimally invasive surgical techniques and approaches, but this approach is not routinely performed for valve-sparing root replacement procedures. The purpose of this study was to assess the safety and feasibility of valve-sparing root replacement via partial upper sternotomy. Between January 2016 and April 2021, 269 patients underwent a valve-sparing root replacement procedure, and partial upper sternotomy was performed in 52 patients. The clinical outcomes of the partial upper sternotomy (PUS) and complete sternotomy (CS) groups, including mortality, degree of aortic insufficiency, blood loss and consumption of blood products, postoperative complications, and hospitalization expenses, were compared. The Kaplan\u2013Meier method was used to assess the degree of aortic regurgitation. Propensity score matching was performed as a sensitivity analysis. There was only one in-hospital death (in the CS group, p = 1) and no postoperative moderate to severe aortic insufficiency in either group. The blood loss and consumption of blood products in the PUS group were also lower than in the CS group, especially for plasma use. Regarding the need for re-exploration because of bleeding, acute kidney injury, pericardial pleural effusion, drainage volume within the first 24 h, mechanical ventilation time, and arrhythmia, the two groups were comparable. Patients in the CS group showed a longer ICU time (74.20 \u00b1 47.21 vs. 50.9 30.16 h, p = 0.001) and higher hospitalization expenses (135,649.52 \u00b1 29,992.21 vs. 123,380.15 \u00b1 27,062.82 yuan, p &lt; 0.001). None of the patients died or reoperated during the follow-up. Freedom from moderate or severe aortic insufficiency remained comparable after matching (p = 0.97). Minimally invasive valve-sparing aortic replacement via partial upper sternotomy can be safely performed in selected patients.<\/jats:p>","DOI":"10.3390\/jcdd8110154","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T12:46:23Z","timestamp":1636461983000},"page":"154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Outcomes of the Valve-Sparing Root Replacement Procedure with Partial Upper Sternotomy"],"prefix":"10.3390","volume":"8","author":[{"given":"Bin","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5793-7951","authenticated-orcid":false,"given":"Rui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"De","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenhua","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7803-5068","authenticated-orcid":false,"given":"Xiaogang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangyang","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuntao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0022-5223(19)34942-6","article-title":"An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta","volume":"103","author":"David","year":"1992","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1016\/j.jtcvs.2012.11.075","article-title":"Long-term results of aortic root repair using the reimplantation technique","volume":"145","author":"David","year":"2013","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1093\/icvts\/ivz180","article-title":"Is valve-sparing root replacement a safe option in acute type A aortic dissection? A systematic review and meta-analysis","volume":"29","author":"Wu","year":"2019","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_4","first-page":"368","article-title":"Minimal-access aortic valve replacement with concomitant aortic procedure: A 9-year experience","volume":"7","author":"Kaneko","year":"2012","journal-title":"Innovations"},{"key":"ref_5","first-page":"212","article-title":"David procedure through an upper partial sternotomy","volume":"4","author":"Shrestha","year":"2015","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1093\/ejcts\/ezaa083","article-title":"Aortic valve-sparing root replacement in patients with bicuspid aortic valve: Long-term outcome with the David I procedure over 20 years","volume":"58","author":"Beckmann","year":"2020","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/HCO.0000000000000713","article-title":"Valve sparing root replacement: An update","volume":"35","author":"Scaffa","year":"2020","journal-title":"Curr. 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Forum"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1053\/j.jvca.2016.07.029","article-title":"Prognosis of Prolonged Intensive Care Unit Stay After Aortic Valve Replacement for Severe Aortic Stenosis in Octogenarians","volume":"30","author":"Augustin","year":"2016","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1053\/j.jvca.2005.07.031","article-title":"Clinical predictors for prolonged intensive care unit stay in adults undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest","volume":"20","author":"Augoustides","year":"2006","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1097\/CCM.0000000000003768","article-title":"Cost-Effectiveness Studies in the ICU: A Systematic Review","volume":"47","author":"Wilcox","year":"2019","journal-title":"Crit. Care Med."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/8\/11\/154\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:28:09Z","timestamp":1760167689000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/8\/11\/154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":19,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["jcdd8110154"],"URL":"https:\/\/doi.org\/10.3390\/jcdd8110154","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,9]]}}}