Conclusion
Our data illustrates that the use of PAR, such as the Freestyle, can be used to replace the diseased aortic root at the time of repair of TAAD with acceptable intra- and post-operative mortality & morbidity. Mid-term survival are satisfactory echocardiographic outcomes are more favourable than CVG in the early phase.  Especially in the elderly population, PAR can be considered as a first line option when indicated. More studies are required to confirm the durability, freedom from structural valve degeneration, and long-term clinical outcomes of this group of patients.