Strengths and limitations
The present study is the first to assimilate clinical data in TAAD
directly comparing the use of PAR to best practice. Our analysis
included survival, as well as echocardiographic data at separate
time-points. However, the retrospective design and small sample size
(n=30 in PAR group, n=35 in CVG group) renders this analysis relatively
underpowered. As our follow-up time was limited to 5 years, valve
durability, especially of PAR could not be adequately analysed, which
may have important relevance beyond 10 years, including the incidence of
structural valve degeneration and need for re-intervention. Future
studies would benefit from long-term echocardiographic and outcome
analysis as well as the effect of either treatment on the prognosis of
the distal aorta and need for intervention on the descending portion.