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Conventional total arch replacement with stented elephant trunk (Sun’s procedure) was compared with one-stop hybrid surgery (total arch replacement plus retrograde stent graft placement under moderate hypothermia). Results: The hybrid group had shorter operative time, cardiopulmonary bypass, cross-clamp, ventilator dependency, and reduced ICU/hospital stays, with fewer complications including pneumonia, severe hypoxemia, stroke, and reoperation for bleeding. CTA showed better aortic remodeling and higher 30-day survival. Conclusion: For selected patients, one-stop hybrid surgery improves perioperative outcomes, morbidity, short-term survival, and quality of life versus Sun’s 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major outcomes favored the hybrid approach?",{"text":72,"@type":64},"Compared with the conventional group, the hybrid group showed shorter operative and support times, shorter ICU and hospital stays, lower postoperative complication rates (including pneumonia, severe hypoxemia, stroke, and bleeding reoperation), improved CTA-based aortic remodeling, and higher 30-day survival.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},457532,1790762658,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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Journal of Cardiothoracic Surgery (2026) 21:15  \n[https://doi.org/10.1186/s13019-025-03639-9](https://doi.org/10.1186/s13019-025-03639-9)  \nJournal of Cardiothoracic Surgery  \nRESEARCH Open Access  \nOne-stop hybrid versus conventional surgery for acute type A aortic dissection:  \na randomized controlled trial  \nWeichao Zhao 1, Mian Li2, Wuhui Hou 1, Xiyan Zhu3 and Qi Hu 1*  \nAbstract  \nObjective This study aimed to comprehensively evaluate the clinical efficacy and prognostic impact of one-stop hybrid surgery in patients diagnosed with Stanford type A aortic dissection, comparing it with conventional surgical approaches aortic arch replacement plus stented elephant trunk (Sun's procedure) .  \nMethods In this prospective, randomized controlled trial, a cohort of 140 patients with acute Stanford type A aortic dissection (TAAD) was prospectively enrolled. Patients were randomized 1:1 into two groups based on treatment modality: the Conventional Group (n = 70), which underwent conventional total arch replacement with stented elephant trunk (Sun's procedure) utilizing deep hypothermic circulatory arrest, and the Hybrid Group (n = 70), which received one-stop hybrid surgery (total arch replacement with a standard four-branched graft and retrograde placement of one or two stent grafts into the descending aorta, performed under moderate hypothermia) .  \nResults Baseline demographic and clinical characteristics were largely comparable between the two groups  \n(P >0. 05), although patients in the Hybrid Group were slightly older (P = 0 . 003) . The Hybrid group exhibited significantly reduced operative times (P \u003C 0. 001), cardiopulmonary bypass durations (P \u003C 0. 001), aortic cross-clamp times (P \u003C 0. 001), and ventilator dependency periods (P \u003C 0. 001) compared to the Conventional group. Patients in the Hybrid Group also had shorter ICU and hospital stays (P \u003C 0. 001) . Postoperative complication rates were markedly lower in the Hybrid group, with significant reductions in pulmonary infections (P = 0 . 009), severe hypoxemia  \n(P = 0 . 032), stroke (P = 0 . 045), and reoperation for bleeding (P = 0 . 038) . Postoperative contrast-enhanced Computed Tomography (CTA) assessments at 1 and 3 months post-surgery revealed superior aortic remodeling in the Hybrid group, as evidenced by significantly lower aortic morphology scores (1 month: P \u003C 0. 001; 3 months: P \u003C 0. 001) . Furthermore, the Hybrid group demonstrated a higher 30-day survival rate (91 .4% vs. 78. 6%, P = 0 . 024), alongside reduced incidences of endoleak (P = 0 . 197) and cardiovascular events (P = 0 . 127) .  \nConclusion One-stop hybrid surgery represents a safe and effective therapeutic strategy for selected patients with Stanford type A aortic dissection, offering superior perioperative outcomes, reduced postoperative morbidity, enhanced short-term survival, and improved quality of life compared to conventional Sun's procedure.  \n*Correspondence:  \nQi Hu [huqi199008032727@163.com](huqi199008032727@163.com)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to","cbCaissrIUuU8xXs","https://ap.wps.com/l/cbCaissrIUuU8xXs","pdf",1562181,"English","# Abstract\n# Introduction","[{\"question\":\"What clinical question does the study address?\",\"answer\":\"The study evaluates the clinical efficacy and prognostic impact of one-stop hybrid surgery compared with conventional surgery (Sun’s procedure) in patients with acute Stanford type A aortic dissection.\"},{\"question\":\"How were patients assigned to treatment groups?\",\"answer\":\"In a prospective randomized controlled trial, 140 acute Stanford type A aortic dissection patients were randomized 1:1 into a Conventional Group (n=70) or a Hybrid Group (n=70) based on the treatment modality.\"},{\"question\":\"What major outcomes favored the hybrid approach?\",\"answer\":\"Compared with the conventional group, the hybrid group showed shorter operative and support times, shorter ICU and hospital stays, lower postoperative complication rates (including pneumonia, severe hypoxemia, stroke, and bleeding reoperation), improved CTA-based aortic remodeling, and higher 30-day survival.\"}]","One-stop hybrid versus conventional surgery for acute type A aortic dissection: a randomized controlled trial | PDF",1790749635,23]