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].