ArticleInterdisciplinary cardiovascular and thoracic surgery2026
Clinical Outcomes of Ascending Aortic Replacement for Aneurysm and the Impact of Centre Volume: A Nationwide Population-Based Study.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate contemporary outcomes of elective ascending aortic replacement (AAR) and the impact of centre volume using a nationwide database.
methodsAdults 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.
resultsAmong 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.
conclusionsElective 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.
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