Strengths and limitations
The present study is the first to assimilate clinical data in TAAD directly comparing the use of PAR to best practice. Our analysis included survival, as well as echocardiographic data at separate time-points. However, the retrospective design and small sample size (n=30 in PAR group, n=35 in CVG group) renders this analysis relatively underpowered. As our follow-up time was limited to 5 years, valve durability, especially of PAR could not be adequately analysed, which may have important relevance beyond 10 years, including the incidence of structural valve degeneration and need for re-intervention. Future studies would benefit from long-term echocardiographic and outcome analysis as well as the effect of either treatment on the prognosis of the distal aorta and need for intervention on the descending portion.