Bentall vs VSRR
It has been a few decades since the original inception of the Bentall method11, undergoing many revolutions in surgical techniques and approaches12; however, this procedure still presents with disadvantages and issues of potential complications.13 Furthermore, under certain indications the Bentall is not always the optimum interventional approach for a root replacement, in some such cases a valve-sparing root replacement (VSRR) can be considered.14 Following the use of a mechanical conduit for root replacement, there is the need of lifelong anticoagulation medication; With the use of a biological conduit there is the higher risk of re-operation, an even greater negative impact on younger patients.13, 14 The VSRR procedure allows the native aortic valve to be preserved, avoiding some of the cons of a complete root replacement, allowing more favorable haemodynamic outcomes.14 In the recent meta-analysis of 9 studies comprising 706 patients treated for ATAAD, VSRR was systematically reviewed as an option for intervention.15 Junlin Wu et al. were able to conclude that the use of VSRR in ATAAD provided highly favorable outcomes in the early and late period in comparison to the patients undergoing Bentall procedure. It should be noted that the authors had clearly stated that these amazing results for VSRR, are only achieved by the carefully considered patient selection process for the procedure.15