[Should Aortic Root Intervention Be Performed in All Cases of Stanford Type A Acute Aortic Dissection?].

To evaluate the outcomes of aortic root preservation in patients undergoing surgery for Stanford type A acute aortic dissection(AAAD)without concomitant root replacement,

Methods

We retrospectively analyzed 79 consecutive AAAD patients(mean age 68±13 years;52% male)who underwent supra-coronary repair(SCR)between January 2012 and December 2022, excluding those requiring Bentall or valve-sparing root replacement(VSRR), Preoperative root involvement, aortic regurgitation(AR), surgical procedures, early outcomes, long-term aortic root dilation, AR progression, and reoperation rates were assessed mean follow-up of 5.7±3.4 years,

Results

Preoperative root dissection was present in 66%, with moderate or greater AR in 16%, Early mortality was low(30-day mortality 2.5%, in-hospital mortality 3.8%), Long-term follow-up, mean aortic root enlargement was minimal(0.28 mm/year), with no cases of progression to moderate or severe AR, Reoperation occurred in 3.8%(3 cases), primarily due to pseudoaneurysm or new entry formation at the proximal anastomosis,

Conclusions

Aortic root preservation with careful proximal anastomosis placement provided excellent early and mid-term outcomes, with minimal late aortic root dilation or AR progression.