Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patients
Abstract This study compared long-term survival and reintervention rates between Valve-Sparing Root Replacement (VSRR, n = 244) and Aortic Root Replacement (ARR, n = 499) in 743 patients undergoing Type A acute aortic dissection (AAD), given the lack of prospective comparative data. Multivariable an...
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| Format: | Article |
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Nature Portfolio
2025-02-01
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| Series: | Nature Communications |
| Online Access: | https://doi.org/10.1038/s41467-025-56509-2 |
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| author | Ling Chen Yichao Pan Huaijian Zhang Yi Chen Chunsheng Wang Zhihuang Qiu Heng Lu Liangwan Chen |
| author_facet | Ling Chen Yichao Pan Huaijian Zhang Yi Chen Chunsheng Wang Zhihuang Qiu Heng Lu Liangwan Chen |
| author_sort | Ling Chen |
| collection | DOAJ |
| description | Abstract This study compared long-term survival and reintervention rates between Valve-Sparing Root Replacement (VSRR, n = 244) and Aortic Root Replacement (ARR, n = 499) in 743 patients undergoing Type A acute aortic dissection (AAD), given the lack of prospective comparative data. Multivariable analysis is identifying advanced age, high Body Mass Index (BMI), Marfan syndrome, severe aortic regurgitation, bicuspid aortic valve, increased aortic root diameter, and reduced aortic cross-clamp time (ACC) as significant factors associated with ARR. After Propensity Score Matching (PSM), VSRR is showing significantly higher 5-year survival rates than ARR (80.2% vs. 64.1%, P = 0.001), validated by Inverse Probability of Treatment Weighting (IPTW) analysis. Reintervention rates are being found comparable, with endocarditis more prevalent in ARR and aortic regurgitation in VSRR. Subgroup analysis indicated that patients aged less than 60 years and those with a BMI greater than 24 in the VSRR group exhibited significantly improved survival probabilities compared to the ARR group. These findings support the wider utilization of valve-sparing root replacement (VSRR) in appropriately selected patients, highlighting its potential advantages for suitable candidates. |
| format | Article |
| id | doaj-art-febbf224dcfa4954a779e348ce93a790 |
| institution | Kabale University |
| issn | 2041-1723 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Nature Communications |
| spelling | doaj-art-febbf224dcfa4954a779e348ce93a7902025-02-02T12:32:30ZengNature PortfolioNature Communications2041-17232025-02-0116111210.1038/s41467-025-56509-2Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patientsLing Chen0Yichao Pan1Huaijian Zhang2Yi Chen3Chunsheng Wang4Zhihuang Qiu5Heng Lu6Liangwan Chen7Department of Cardiac Surgery, Fujian Medical University Union Hospital, FuzhouDepartment of Anesthesiology, Zhangzhou Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen UniversityDepartment of Cardiac Surgery, Fujian Medical University Union Hospital, FuzhouDepartment of Cardiac Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Cardiac Surgery, Fujian Medical University Union Hospital, FuzhouDepartment of Cardiac Surgery, Fujian Medical University Union Hospital, FuzhouDepartment of Cardiac Surgery, Fujian Medical University Union Hospital, FuzhouAbstract This study compared long-term survival and reintervention rates between Valve-Sparing Root Replacement (VSRR, n = 244) and Aortic Root Replacement (ARR, n = 499) in 743 patients undergoing Type A acute aortic dissection (AAD), given the lack of prospective comparative data. Multivariable analysis is identifying advanced age, high Body Mass Index (BMI), Marfan syndrome, severe aortic regurgitation, bicuspid aortic valve, increased aortic root diameter, and reduced aortic cross-clamp time (ACC) as significant factors associated with ARR. After Propensity Score Matching (PSM), VSRR is showing significantly higher 5-year survival rates than ARR (80.2% vs. 64.1%, P = 0.001), validated by Inverse Probability of Treatment Weighting (IPTW) analysis. Reintervention rates are being found comparable, with endocarditis more prevalent in ARR and aortic regurgitation in VSRR. Subgroup analysis indicated that patients aged less than 60 years and those with a BMI greater than 24 in the VSRR group exhibited significantly improved survival probabilities compared to the ARR group. These findings support the wider utilization of valve-sparing root replacement (VSRR) in appropriately selected patients, highlighting its potential advantages for suitable candidates.https://doi.org/10.1038/s41467-025-56509-2 |
| spellingShingle | Ling Chen Yichao Pan Huaijian Zhang Yi Chen Chunsheng Wang Zhihuang Qiu Heng Lu Liangwan Chen Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patients Nature Communications |
| title | Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patients |
| title_full | Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patients |
| title_fullStr | Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patients |
| title_full_unstemmed | Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patients |
| title_short | Propensity score matching analysis of valve-sparing versus aortic root replacement in type A aortic dissection patients |
| title_sort | propensity score matching analysis of valve sparing versus aortic root replacement in type a aortic dissection patients |
| url | https://doi.org/10.1038/s41467-025-56509-2 |
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