Reviews in cardiovascular medicine最新文献

{"title":"Short-Term Efficacy of Early Sodium-Glucose Cotransporter 2 Inhibitor Initiation in Patients With Heart Failure After Acute Anterior Myocardial Infarction.","authors":"Shuli Bi, Dong Li, Jianping Du, Wenting Li, Xiaoyu Yang, Wenqi Tao, Yan Zhang, Weiyuan Zhang, Zhuhua Yao","doi":"10.31083/RCM48719","DOIUrl":"10.31083/RCM48719","url":null,"abstract":"<p><strong>Background: </strong>Patients with heart failure (HF) following acute anterior ST-segment elevation myocardial infarction (STEMI) are at high risk for adverse ventricular remodeling, and a significant residual risk persists despite optimal guideline-directed medical therapy (GDMT). Although sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated clear benefit in chronic HF, evidence is limited regarding the early initiation of these inhibitors after acute myocardial infarction (MI), particularly in patients with HF complicating anterior wall infarction. Therefore, this study aimed to evaluate the short-term effects of early initiation of the SGLT2 inhibitor (SGLT2i) empagliflozin, when added to standard medical therapy, on cardiac function and safety in patients with HF following acute anterior STEMI.</p><p><strong>Methods: </strong>This single-center retrospective cohort study consecutively enrolled 98 patients hospitalized at Tianjin Union Medical Center between January 2022 and December 2022 with acute anterior STEMI complicated by HF. Patients were divided into two groups based on SGLT2i use: the control group (n = 49) received standard medical therapy alone, while the SGLT2i group (n = 49) received empagliflozin 10 mg once daily in addition to standard therapy. The primary outcome was the change in left ventricular ejection fraction (LVEF) from admission to one month after discharge. Analysis of covariance (ANCOVA) and multivariable linear regression models were employed to adjust for potential confounders.</p><p><strong>Results: </strong>Baseline characteristics were well-balanced between the two groups. At one-month follow-up, the SGLT2i group showed a significantly greater improvement in LVEF than the control group, with a multivariable-adjusted effect size of 1.92% (95% confidence interval (CI): 0.44-3.40%; <i>p</i> = 0.012). Serum uric acid levels were significantly lower in the SGLT2i group than in the control group (<i>p</i> = 0.006). In both groups, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels decreased from baseline to one-month follow-up, with no significant between-group difference. The incidence of adverse events was similar between groups, and no cases of ketoacidosis or severe deterioration in renal function were observed.</p><p><strong>Conclusion: </strong>In hemodynamically stable patients with acute anterior STEMI complicated by HF, early initiation of SGLT2 inhibitors was associated with higher LVEF at 1 month and a trend toward lower uric acid levels, without significant differences in safety outcomes between groups. These preliminary findings suggest potential benefit and warrant confirmation in prospective studies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"48719"},"PeriodicalIF":2.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity in Arrhythmogenic Cardiomyopathy: From Trigger to Therapeutic Dilemma.","authors":"Elham Kayvanpour, Benjamin Meder, Farbod Sedaghat-Hamedani","doi":"10.31083/RCM52871","DOIUrl":"10.31083/RCM52871","url":null,"abstract":"<p><p>Arrhythmogenic cardiomyopathy (ACM) is highly sensitive to environmental influences, with physical exercise emerging as one of the most important determinants of disease expression. Growing evidence indicates that high-intensity and endurance exercise accelerate structural remodelling, promote inflammatory myocardial injury, and increase the incidence of malignant ventricular arrhythmias in genetically predisposed individuals. These effects extend beyond acute exertion, as cumulative exercise exposure contributes to the development of a persistent arrhythmogenic substrate that may sustain risk even after cessation of competitive sport. In contrast, available data suggest that low-intensity physical activity does not confer the same degree of arrhythmic burden and may support overall cardiovascular and functional health when carefully prescribed. This review integrates mechanistic insights, clinical cohort data, and current guideline recommendations to provide a balanced framework for exercise counselling in ACM. Rather than advocating complete physical inactivity, this approach differentiates high-risk endurance or competitive exercise from carefully selected low-intensity recreational activity and emphasizes individualized, shared decision-making. Thus, understanding the interaction among genetic substrate, exercise intensity, and systemic stressors is essential for optimizing personalized activity recommendations and improving long-term outcomes in this vulnerable population.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"52871"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Assisted Intravascular Imaging in Percutaneous Coronary Intervention: Current Status and Advances.","authors":"Zihan Li, Yuwei Wang, Ben Hu, Ziyang Ren, Jiawei Wu","doi":"10.31083/RCM49881","DOIUrl":"10.31083/RCM49881","url":null,"abstract":"<p><p>Over the past two decades, intravascular imaging (IVI) has been widely integrated into clinical practice. Unlike traditional angiography, IVI uses an intracoronary imaging catheter to generate high-resolution cross-sectional images of diseased coronary arteries, thereby facilitating lesion characterization. These detailed images enable more accurate guidance of percutaneous coronary intervention (PCI). The clinical utility of IVI is demonstrated across four key stages: preoperative lesion assessment, intraoperative procedural guidance, postoperative complication detection, and evaluation of stent optimization. Despite these benefits, interventionalists continue to face challenges in consistently acquiring and interpreting high-quality IVI data. The emergence of artificial intelligence (AI) offers a promising solution by enabling precise image recognition and automated quantitative analysis, thereby supporting efficient clinical decision-making and broadening the scope of IVI applications. This review aims to summarize recent research progress in AI-assisted IVI across the PCI process and discuss future directions to improve the intelligence and efficiency of intravascular imaging.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"49881"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimensional Perspective on Scar-Related Ventricular Tachycardia Substrate: Critical Conduction Abnormalities as Ablation Targets and Implications for Procedural Endpoints.","authors":"Yuki Komatsu, Akihiko Nogami","doi":"10.31083/RCM51668","DOIUrl":"10.31083/RCM51668","url":null,"abstract":"<p><p>Scar-related ventricular tachycardia (VT) is increasingly recognized as a three-dimensional (3D) arrhythmia sustained by complex reentrant circuits that frequently involve intramural components. Advances in high-density and high-resolution electroanatomical mapping have shifted the paradigm of substrate characterization from purely voltage-based structural definitions toward functional assessment of conduction delay and wavefront discontinuity. Recent studies have described techniques that target critical conduction abnormalities associated with VT circuits, including deceleration zones, lines of conduction block, and rotational activation patterns. A central concept underlying these approaches is that VT substrates are volumetric structures constrained by lateral and depth-oriented boundaries rather than planar pathways. Within this 3D framework, targeted ablation strategies that interrupt functionally relevant conduction abnormalities, rather than empirically modifying scar, have demonstrated clinical outcomes comparable to those of extensive homogenization approaches while potentially reducing procedural burden. Intramural reentry remains a major challenge because surface-based mapping incompletely captures mid-myocardial conduction, and current techniques for real-time intraprocedural assessment of intramural abnormalities remain limited. Adjunctive strategies, including differential pacing, refined annotation methods, and peak frequency analysis, may improve identification of critical substrate components, although no single parameter reliably defines the optimal ablation target. Accordingly, procedural endpoints should evolve beyond empirical surrogates such as VT termination or noninducibility toward confirmation of effective disruption of the 3D arrhythmogenic substrate. Continued integration of advanced mapping technologies, imaging, and lesion-delivery innovations will be essential to refine both ablation strategies and procedural endpoints in scar-related VT.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"51668"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrated Therapeutic Strategy for Cardiorenal Syndrome to Target Oxidative Stress, Inflammation, and Fibrosis.","authors":"Xinwei Wang, Qiongyao He, Desen Yang, Yaoyao Guo, Siyu Fu, Wu He","doi":"10.31083/RCM50347","DOIUrl":"10.31083/RCM50347","url":null,"abstract":"<p><p>Cardiorenal syndrome (CRS) is characterized by a complex, bidirectional interaction between cardiac and renal dysfunction, posing a significant challenge in clinical practice. Although these two organ dysfunctions share common pathophysiological pathways, there remains a major unmet need for therapies that specifically target these shared mechanisms. Oxidative stress, chronic low-grade inflammation, and progressive tissue fibrosis are pivotal, interconnected drivers involved in the progression of both chronic heart failure and chronic kidney disease, constituting a critical pathological triad in CRS. This review aims to systematically elucidate the interplay among reactive oxygen species (ROS), immune cell infiltration, proinflammatory cytokine signaling, and fibrotic pathway activation in the pathogenesis of CRS. We also provide a comprehensive overview of the current landscape of novel pharmacological candidates that target key nodes in the oxidative stress-inflammation-fibrosis axis, including small molecules, biologics, and repurposed drugs. By integrating preclinical evidence with clinical trial data, this review highlights the therapeutic potential of concurrently attenuating oxidative stress, inflammation, and fibrosis to disrupt the vicious cycle of CRS and ultimately improve patient outcomes.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"50347"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Oral Anticoagulants Versus Vitamin K Antagonists for Treatment of Left Ventricular Thrombus: A Review of Efficacy and Safety.","authors":"Malik Alqawasmi, Osaid Alrahamneh, Altamash Jawadi, James C Blankenship","doi":"10.31083/RCM50947","DOIUrl":"10.31083/RCM50947","url":null,"abstract":"<p><p>Left ventricular thrombus (LVT) remains a critical complication of acute myocardial infarction (MI), particularly in patients with anterior ST-segment elevation myocardial infarction (STEMI) and apical dysfunction. While primary percutaneous coronary intervention (PCI) has reduced its overall incidence compared with the pre-thrombolytic era, LVT continues to pose a significant risk of systemic embolization and stroke, driven by the interplay of endothelial injury, hypercoagulability, and stasis within the aneurysmal apex. This review synthesizes current evidence on the pathophysiology, diagnosis, and management of LVT. We critically evaluate diagnostic modalities, highlighting the substantial sensitivity gap between the clinical standard, transthoracic echocardiography (TTE), and the gold standard, cardiac magnetic resonance (CMR). This discrepancy has important implications for clinical decision-making, as TTE often overestimates thrombus resolution, potentially leading to the premature cessation of therapy. Therapeutically, the landscape has shifted from the empiric use of vitamin K antagonists (VKAs) toward the adoption of direct oral anticoagulants (DOACs). Thus, we analyze recent randomized data, including the Comparative Study of Oral Anticoagulation in Left Ventricular Thrombi (No-LVT) and the Rivaroxaban vs Warfarin in Acute Left Ventricular Thrombus Following Myocardial Infarction (RIVAWAR) trials, which demonstrate that DOACs are non-inferior to VKAs for embolic prevention and may offer superior resolution velocity, a crucial metric for stabilizing friable thrombi. We conclude that DOACs represent a reasonable, patient-centered alternative to warfarin. Nonetheless, future management strategies must integrate precise, serial imaging with rapid-onset anticoagulation to ensure complete histologic resolution while minimizing the hemorrhagic burden of prolonged triple antithrombotic therapy.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"50947"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Surgery Management in Patients With Liver Cirrhosis.","authors":"Adam Ryszard Kowalówka, Mikołaj Jodłowski, Aleksandra Kiszka, Ryszard Bachowski, Radosław Gocoł","doi":"10.31083/RCM49476","DOIUrl":"10.31083/RCM49476","url":null,"abstract":"<p><p>Liver cirrhosis substantially increases perioperative morbidity and mortality in patients undergoing cardiac surgery through coagulopathy, portal hypertension, cirrhotic cardiomyopathy, renal dysfunction, and immune dysregulation. Conventional cardiac risk scores underestimate this risk because these metrics do not incorporate variables related to hepatic function, highlighting the need to integrate the Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores. Novel predictive models, such as the Veterans Outcomes and Costs Associated with Liver Disease - Penn (VOCAL-Penn) and Mayo Postoperative Mortality Risk Score (Mayo scores), demonstrate superior discriminatory performance by incorporating surgery-specific variables. This narrative review synthesizes the evidence on risk stratification, preoperative optimization, intraoperative management, and postoperative care in patients with liver cirrhosis undergoing cardiac surgery. A structured, multidisciplinary approach that incorporates systematic hepatic assessment, careful patient selection using integrated cardiac-hepatic risk models, tailored intraoperative techniques to minimize cardiopulmonary bypass (CPB)-related injury, and vigilant postoperative organ support can improve outcomes in this high-risk population. This review provides practical, phase-oriented recommendations with evidence grading, critical discussion of controversies, and acknowledgment of the limitations inherent in the available literature.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"49476"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular Imaging to Predict the Coronary No-Reflow and Slow-Flow Phenomena: Advances and Perspectives.","authors":"Yaokun Zhan, Qili Huang, Qingkuan Li, Huayuan Zeng, Ying Shi, Zhengde Lu, Huili Li, Junpeng Xiao, Hongqing Li, Yingzhong Lin, Qingwei Ji","doi":"10.31083/RCM47922","DOIUrl":"10.31083/RCM47922","url":null,"abstract":"<p><p>Coronary no-reflow (NF) and slow-flow (SF) are serious complications following percutaneous coronary intervention (PCI) and are associated with adverse prognoses, with microvascular obstruction (MVO) as the central underlying mechanism. Intravascular imaging techniques, including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near-infrared spectroscopy (NIRS), enable high-resolution, multidimensional (structural, compositional, and functional) assessment of coronary lesions, thereby facilitating prediction of coronary NF and SF. IVUS, with a penetration depth of 4-8 mm, can identify predictive features such as plaque rupture, attenuated plaque, positive remodeling, and large necrotic cores. OCT, with a spatial resolution of 10-20 μm and a penetration depth of 1-2 mm, is capable of detecting thin-cap fibroatheromas, cholesterol crystals, and intraplaque vasa vasorum. NIRS quantifies lipid content using the parameter maximum 4 mm lipid core burden index (maxLCBI_4mm), which demonstrates favorable predictive performance for NF and SF phenomena. When the OCT-derived fibrous cap thickness is <55 µm, the area under the curve (AUC) for predicting NF is 0.985 (95% confidence interval (CI): 0.968-1.000); meanwhile, the corresponding sensitivity and specificity for predicting SF are 93.5% and 96.7%, respectively. When the NIRS-derived maxLCBI_4mm is ≥578, the AUC for predicting SF is 0.849.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"47922"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Catheter Ablation of Ventricular Tachycardia: Technical Considerations and Contemporary Approaches.","authors":"Corrado De Marco, Alexios Hadjis, Wouter Saint-Phard, Jean-Marc Raymond","doi":"10.31083/RCM52698","DOIUrl":"10.31083/RCM52698","url":null,"abstract":"<p><p>Ventricular tachycardia (VT) is a life-threatening arrhythmia that most commonly arises from reentrant circuits within myocardial scar in patients with structural heart disease. Although implantable cardioverter-defibrillators (ICDs) reduce sudden cardiac death, these devices do not prevent VT and are associated with significant physical and psychological burdens, while antiarrhythmic drug therapy is often limited by incomplete efficacy and adverse effects. These limitations have driven the increasing use of catheter ablation to target arrhythmogenic substrates. This review examines the evolving role of catheter ablation in VT management, including the supporting evidence, patient selection, procedural timing, and contemporary mapping and ablation strategies, drawing on data from randomized clinical trials, observational studies, and recent technological advances. Multiple trials, including SMASH-VT, VTACH, VANISH, SURVIVE-VT, and VANISH-2, have shown that catheter ablation reduces VT recurrence and ICD therapies, with growing evidence supporting the earlier or even first-line use of this technique in selected patients. Substrate-based ablation has become the cornerstone of modern practice, enabling effective treatment during sinus rhythm; meanwhile, preprocedural imaging, such as cardiac magnetic resonance and computed tomography, enhances scar characterization and procedural planning. Advanced approaches, including epicardial ablation, bipolar and needle ablation, and alternative energy delivery techniques, help overcome the limitations of conventional endocardial radiofrequency lesions. Emerging modalities, such as pulsed field ablation, show promise but require further validation. Despite these advances, VT-free survival remains approximately 50-60%, reflecting the complexity of the underlying arrhythmogenic substrates. Overall, catheter ablation has become an integral component of contemporary VT management, offering meaningful reductions in arrhythmia burden and ICD therapies, with increasing use earlier in the disease course; meanwhile, ongoing innovations in mapping, imaging integration, and energy delivery are expected to improve outcomes further, pending continued investigation into optimal patient selection, procedural timing, and long-term efficacy.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"52698"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Selective Sinus Reinforcement Technique for Acute Type A Aortic Dissection Involving the Aortic Root.","authors":"Hua-Jie Zheng, Ling-Ling Zeng, Yong-Bo Cheng, Mao-Ting Ye, Mei Guo, Ling-Feng Tang, Wei Cheng","doi":"10.31083/RCM49343","DOIUrl":"10.31083/RCM49343","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (ATAAD) commonly involves the aortic root. We developed a novel selective sinus reinforcement (SSR) technique. This study aimed to investigate the feasibility, effectiveness and safety of this technique.</p><p><strong>Methods: </strong>Between January 2018 and January 2022, a total of 361 consecutive patients underwent surgery for ATAAD. Of these, 186 patients (51.5%) were treated using the SSR technique to repair the involved root.</p><p><strong>Results: </strong>The extent of sinus repair was stratified as follows: single sinus in 62.9%, two sinuses in 30.1%, and all three sinuses in 7.0%. Postoperatively, 5 patients (2.7%) required re-exploration for bleeding unrelated to the root procedure. At a mean follow-up of 35.2 ± 8.5 months, the 3-year overall survival rate was 94.6%. One patient required valve reintervention at 2 years due to late prolapse with severe aortic insufficiency.</p><p><strong>Conclusions: </strong>For ATAAD involving the root, the SSR technique offers a simplified and potentially safer surgical alternative, demonstrating durable aortic valve competence and excellent root stability.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 8","pages":"49343"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}