Abstract: Background: The COVID-19 pandemic in late 2019 quickly stretched health care system across the globe. Mortalities, shortages in health care system capacity, and lack of experience in similar circumstances required innovation in the way health care is delivered. Health care systems changed operating schedules, staff work pattern, and how patients are cared for. The effects of these changes reached patients, staff and training in different ways. Methods: We search the Pubmed and EMBASE for articles related to COVID-19. We also searched local e-mails and information provided to staff during the pandemic Results: The COVID-19 pandemic affected organisations, patients and staff. The organisation and staff had to adapt to the times to provide a safe and appropriate service to our patients. Conclusion: The pandemic challenged and changed the way we work as health care providers, and how we train the future surgeons. Changes in the system was effective.

Background: Type A acute aortic dissection (TAAAD) is rapidly fatal without emergency surgical. Surgical outcomes have improved over the years with improvements in technique and postoperative care. Classically, supracomissural aortic replacement has been the standard of care. However, reintervention rates, particularly on the aortic root, in certain groups of patients shifted the focus towards improving long terms results of surgical repair. With regard to the aortic root, root replacement has been the gold standard. However, the surgical community realised that valve replacement in itself is a disease, and valve sparing aortic root replacement (VSRR) took centre stage in the care of these patients. Methods: We search the Pubmed and EMBASE for articles related to VSRR, composite valve conduit root (CVC) replacement, and the long terms results of both in TAAAD. Results: Supracomissural repair is limited by reintervention and CVC results are affected by complications related to the prosthetic valve. Conversely, VSRR is associated with good short-term outcomes, improvement in quality of life, and it is durable. Conclusion: VSRR is a sound technique in TAAAD in experienced hands.