Yerokun BA, Vallabhajosyula P, Vekstein AM, et al. - The long-term outcomes of different surgical approaches to aortic root repair (ARR) were compared in Medicare patients utilizing Society of Thoracic Surgeons Adult Cardiac Surgery Database-Centers for Medicare & Medicaid Services (STS ACSD-CMS) linked data. They identified a total of 4,173 patients aged ≥ 65 years who underwent elective aortic root repair. Stratification of patients was done by operative strategy: mechanical Bentall (MB), stented bioprosthetic Bentall (BB), stentless BB, or valve-sparing root replacement (VSRR). As per outcomes, patients undergoing MB had poorer late survival and greater late stroke risk and patients undergoing VSRR had a higher rate of re-intervention. They suggest bioprosthetic Bentall as possibly the procedure of choice for older patients undergoing ARR, particularly in the era of transcatheter aortic valve replacement.