What is the clinical evidence from this study?

Study design: Cohort. Population: Acute Stanford Type A Aortic Dissection (n=82). Intervention: Valve-sparing root replacement vs. Bentall procedure. Primary outcome: All-cause mortality (HR 0.83, 95% CI 0.29-2.33, p=0.718).

What question did this study set out to answer?

To compare early and long-term clinical outcomes between valve-sparing root replacement (VSRR) and the Bentall procedure in patients undergoing emergency aortic root intervention for acute Stanford type A aortic dissection (ATAAD).

August 14, 2026The Korean Journal of Thoracic and Cardiovascular SurgeryOpen Access

Comparison of Outcomes between Valve-Sparing Root Replacement and the Bentall Procedure in Acute Stanford Type A Aortic Dissection: A Single-Center Retrospective Cohort Study in South Korea

Q: What does this research mean for the field?

Valve-sparing root replacement shows no significant difference in all-cause mortality or major adverse clinical outcomes compared to the Bentall procedure in patients with acute Stanford type A aortic dissection. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

View Full Paper

Ask AI

Bookmark

Key result

Valve-sparing root replacement shows no mortality benefit over the Bentall procedure in acute aortic dissection.

HR 0.83
95% CI 0.29-2.33
P=0.718
n=82

Why the study?

Comparative evidence for valve-sparing root replacement versus the Bentall procedure in acute Stanford type A aortic dissection remains limited.

Does valve-sparing root replacement improve outcomes compared to the Bentall procedure in patients with acute Stanford type A aortic dissection requiring aortic root intervention?

Population

82 patients with ATAAD undergoing emergency aortic root intervention

Comparison

Valve-sparing root replacement vs Bentall procedure

Design

Single-center retrospective cohort study with IPTW

Follow-up

Median 6.02 years

Authors

SOSaori OshiroTokyo Women's Medical University KKKi Tae KimUlsan College HKHong Rae KimUlsan College

Discussion

Member takes

Implication

No clear adjusted differences support selective VSRR consideration in ATAAD; leaves open need for larger multicenter trials on durability.

Key Points

To compare early and long-term clinical outcomes between valve-sparing root replacement (VSRR) and the Bentall procedure in patients undergoing emergency aortic root intervention for acute Stanford type A aortic dissection (ATAAD).
Retrospectively analyzed 82 patients with ATAAD who received emergency aortic root repair (VSRR, n=17; Bentall procedure, n=65) at Asan Medical Center in South Korea between 1994 and 2022.
Stabilized inverse probability of treatment weighting (IPTW) was applied using 6 prespecified clinical covariates to balance baseline characteristics.
Cox proportional hazards models evaluated all-cause mortality and composite outcomes, while Fine-Gray competing risk regression analyzed stroke, infective endocarditis, bleeding, and reoperation over a median follow-up of 6.02 years.
Over a median follow-up of 6.02 years (interquartile range, 1.22–15.42 years), adjusted all-cause mortality (HR, 0.83; 95% CI, 0.29–2.33; p=0.718) and composite outcomes (HR, 0.70; 95% CI, 0.32–1.53; p=0.368) showed no statistically significant differences between VSRR and the Bentall procedure.
Competing risk analyses revealed no significant differences in stroke (sHR, 0.90; 95% CI, 0.15–5.37; p=0.908), infective endocarditis (sHR, 0.30; 95% CI, 0.004–21.34; p=0.582), hemorrhagic events (sHR, 0.68; 95% CI, 0.07–6.61; p=0.743), or reoperation (sHR, 0.13; 95% CI, 0.004–4.80; p=0.269).

Study Design

Type

Cohort (n=82)

Multicenter

Structured PICO

Does valve-sparing root replacement improve outcomes compared to the Bentall procedure in patients with acute Stanford type A aortic dissection requiring aortic root intervention?

Population

82 patients with acute Stanford type A aortic dissection requiring emergency aortic root intervention, followed for a median of 6.02 years.

Intervention

Valve-sparing root replacement (VSRR) using the reimplantation technique

Comparator

Bentall procedure (aortic root and valve replaced with a composite valved conduit, mechanical or bioprosthetic)

Outcome

All-cause mortalityhard clinical

Main Result

Hazard Ratio: 0.83 (95% CI 0.29–2.33)

p-value: p=0.718

In patients with acute Stanford type A aortic dissection requiring aortic root intervention, valve-sparing root replacement and the Bentall procedure demonstrated comparable early and long-term outcomes.

Limitations

Small sample size and unbalanced cohort (17 VSRR vs 65 Bentall)
Limited number of outcome events, likely underpowered to detect modest differences
Differences in follow-up duration between groups
Retrospective, single-center design with potential residual confounding
Long study period (1994-2022) with changes in surgical techniques and management
Preoperative echocardiographic assessments not uniformly available due to emergency setting
Small number of events and wide confidence intervals
Follow-up duration differed between the groups
Single-center cohort
Retrospective design

Cite This Study

Oshiro et al. (2026) conducted a cohort in Acute Stanford Type A Aortic Dissection (n=82). Valve-sparing root replacement vs. Bentall procedure was evaluated on All-cause mortality (HR 0.83, 95% CI 0.29-2.33, p=0.718). Valve-sparing root replacement showed no significant difference in all-cause mortality compared to the Bentall procedure in patients with acute Stanford type A aortic dissection (HR 0.83).

synapsesocial.com/papers/6a7ec775b70b84ec8b913e37 https://doi.org/10.5090/jcs.26.031

View Full Paper

Ask AI

Bookmark

Implication

No clear adjusted differences support selective VSRR consideration in ATAAD; leaves open need for larger multicenter trials on durability.

Comparison of Outcomes between Valve-Sparing Root Replacement and the Bentall Procedure in Acute Stanford Type A Aortic Dissection: A Single-Center Retrospective Cohort Study in South Korea

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Comparison of Outcomes between Valve-Sparing Root Replacement and the Bentall Procedure in Acute Stanford Type A Aortic Dissection: A Single-Center Retrospective Cohort Study in South Korea

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider