Does adding a root replacement in type A aortic dissection repair provide better outcomes?

There exists much controversy regarding fate of the aortic root in ATAAD. There are conflicting studies for impact of root replacement on mortality, whilst some study's report no significant results at all. There is strong evidence regarding risk of reoperation being greater when root is not replaced. Majority of these studies are limited by the single centered, retrospective nature of these small sample sized cohorts, further hindered by potential of treatment bias.