{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T17:49:27Z","timestamp":1778780967691,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Aortic valve-sparing aortic root replacement (VSARR) David procedure has not been routinely performed via minimally invasive access due to its complexity. Methods: We compared our results for mini-VSARR to sternotomy-VSARR from another excellence center. Results: Eighty-four patients, 62 in the sternotomy-VSARR group and 22 in the mini-VSARR group, were included. A baseline, the aneurysm dimensions were higher in the mini-VSARR group. Propensity matching resulted in 17 pairs with comparable characteristics. Aortic cross-clamp and cardiopulmonary bypass times were significantly longer in the mini-VSARR group, by 60 and 20 min, respectively (p &lt; 0.001). In-hospital outcomes were comparable between the groups. Drainage volumes were numerically lower, and hospital length of stay was, on average, 3 days shorter (p &lt; 0.001) in the mini-VSARR group. At a median follow-up of 5.5 years, there was no difference in mortality (p = 0.230). Survival at 1, 5 and 10 years was 100%, 100%, and 95% and 95%, 87% and 84% in the mini-VSARR and sternotomy-VSARR groups, respectively. No repeat interventions on the aortic valve were documented. Echocardiographic follow-up was complete in 91% with excellent durability of repair regardless of the approach: no cases of moderate\/severe aortic regurgitation were reported in the mini-VSARR group. Conclusions: The favorable outcomes, reduced drainage, and shorter hospital stays associated with the mini-sternotomy approach underscore its potential advantages expanding beyond cosmetic outcome.<\/jats:p>","DOI":"10.3390\/jcm13092692","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T09:39:47Z","timestamp":1714729187000},"page":"2692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach"],"prefix":"10.3390","volume":"13","author":[{"given":"Jakub","family":"Starom\u0142y\u0144ski","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, 85-067 Bydgoszcz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Kowal\u00f3wka","sequence":"additional","affiliation":[{"name":"Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, 85-067 Bydgoszcz, Poland"},{"name":"Department of Cardiac Surgery, Upper-Silesian Heart Center, 40-635 Katowice, Poland"},{"name":"Department of Cardiac Surgery, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rados\u0142aw","family":"Goco\u0142","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Upper-Silesian Heart Center, 40-635 Katowice, Poland"},{"name":"Department of Cardiac Surgery, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian","family":"Hudziak","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Upper-Silesian Heart Center, 40-635 Katowice, Poland"},{"name":"Department of Cardiac Surgery, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"\u017burawska","sequence":"additional","affiliation":[{"name":"Clinical Cardiology Department, National Medical Institute of the Ministry of Interior and Administration, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Pasierski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, 85-067 Bydgoszcz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Sarnowski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rados\u0142aw","family":"Smoczy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Bartczak","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakub","family":"Br\u0105czkowski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina","family":"Sadecka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6685-3757","authenticated-orcid":false,"given":"Dominik","family":"Drobi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Deja","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Upper-Silesian Heart Center, 40-635 Katowice, Poland"},{"name":"Department of Cardiac Surgery, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Szyma\u0144ski","sequence":"additional","affiliation":[{"name":"Clinical Cardiology Department, National Medical Institute of the Ministry of Interior and Administration, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Suwalski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, 85-067 Bydgoszcz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5478-3245","authenticated-orcid":false,"given":"Mariusz","family":"Kowalewski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, 85-067 Bydgoszcz, Poland"},{"name":"Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/HCO.0000000000000902","article-title":"Surgical options for aortic root aneurysm disease: Which procedure, which 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