Fig. 5: Consort diagram of patients with acute type A aortic dissection undergoing VSRR or ARR root replacement.

A total of 864 surgeries were performed during February 2013 to February 2019. Of these, 121 surgeries were excluded for various reasons: 47 due to infective endocarditis, 62 due to prior AV surgery, 11 due to non-David V (DV) or Bentall surgery, and 1 due to being a second surgery in the database. The final cohort for analysis, by either ARR or valve-sparing root replacement (VSRR), included 743 surgeries. Among these, 499 surgeries involved aortic root replacement (ARR) with valve replacement, while 244 surgeries involved valve-sparing root replacement (VSRR). The symbols used in the flowchart are as follows: ● represents excluded cases. AV aortic valve.