Interdisciplinary cardiovascular and thoracic surgery · 2026
Clinical Outcomes of Ascending Aortic Replacement for Aneurysm and the Impact of Centre Volume: A Nationwide Population-Based Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kim Sue Hyun, Kim Jinhee, Kang Yoonjin, Sohn Suk Ho, Lee Yeiwon, Hwang Ho Young, Kim Kyung Hwan, Kim Mi-Sook, Choi Jae Woong
Аннотация
OBJECTIVES: To evaluate contemporary outcomes of elective ascending aortic replacement (AAR) and the impact of centre volume using a nationwide database.
METHODS: Adults undergoing elective AAR for aneurysms (2003-2021) were identified from the Korean National Health Insurance Service database. Acute dissections, ruptures, and arch involvements were excluded. Restricted cubic splines (RCS) and multivariable regression evaluated the impact of institutional volume and concomitant procedures.
RESULTS: Among 5209 patients, operative mortality and stroke rates were 2.9% and 2.2%. Over a 5.9-year median follow-up, RCS revealed a significant non-linear inverse relationship between annual institutional volume and mortality. Treatment at high-volume centres (≥10 cases/year) independently lowered operative mortality (odds ratio, 0.26; 95% CI, 0.18-0.37) and long-term mortality (hazard ratio, 0.64; 95% CI, 0.57-0.73). Distinct clinical phenotypes, including bicuspid aortic valves and concomitant aortic valve surgery, were associated with favourable survival.
CONCLUSIONS: Elective AAR demonstrates low perioperative risk and stable long-term survival, significantly influenced by annual institutional volume and clinical phenotypes. These findings support dedicated aortic centres and individualized risk stratification.
METHODS: Adults undergoing elective AAR for aneurysms (2003-2021) were identified from the Korean National Health Insurance Service database. Acute dissections, ruptures, and arch involvements were excluded. Restricted cubic splines (RCS) and multivariable regression evaluated the impact of institutional volume and concomitant procedures.
RESULTS: Among 5209 patients, operative mortality and stroke rates were 2.9% and 2.2%. Over a 5.9-year median follow-up, RCS revealed a significant non-linear inverse relationship between annual institutional volume and mortality. Treatment at high-volume centres (≥10 cases/year) independently lowered operative mortality (odds ratio, 0.26; 95% CI, 0.18-0.37) and long-term mortality (hazard ratio, 0.64; 95% CI, 0.57-0.73). Distinct clinical phenotypes, including bicuspid aortic valves and concomitant aortic valve surgery, were associated with favourable survival.
CONCLUSIONS: Elective AAR demonstrates low perioperative risk and stable long-term survival, significantly influenced by annual institutional volume and clinical phenotypes. These findings support dedicated aortic centres and individualized risk stratification.