Compared with concomitant aortic wrapping or replacement,
AVR alone achieved similar clinical outcomes,
showing considerably low risks of adverse aortic events
or relevant aortic expansion in dilated ascending aorta.
These findings argue against routine aortic replacement at
the time of AVR. Further large-scale studies are mandatory
to define proper indications of concomitant aorta replacement
during AVR, considering the surgical risks and
long-term benefits.