Discussion
This single centre retrospective case series analysed the performance of the native aortic valve and root following surgery for ATAAD. Mortality was observed to be lower in patients undergoing resuspension of the native aortic valve compared to aortic root replacement in this series. The difference in observed mortality during the follow-up period was accounted for by higher, 30-day, operative mortality in patients where the aortic valve was replaced. Although surgical risk, as assessed by Euroscore II, was comparable between the two cohorts, patients where the native aortic valve was preserved had significantly lower mortality than might be expected by pre-operative risk scoring. This is contrast to most studies, including several metanalyses, which have suggested comparable mortality between aortic valve resuspension and ARR for ATAAD [11][12].