Background: This study investigated early and midterm outcomes after valve-sparing aortic root replacement (VSSR procedure with De Paulis Valsalva graft) for acute aortic dissection or ascending aortic aneurysm in a single Chinese hospital center. Methods: Between September 2005 to July 2013, 38 patients (84.2 % male; mean age, 45.5 +/- 12.4) underwent VSSR procedure with De Paulis valsalva graft for acute aortic dissection or ascending aortic aneurysm and were followed up clinically and echocardiographically. Results: Among the 38 cases studied, intensive care unit stay duration was 34.5 (interquartile range, 16-34.6) days; hospital stay duration was 11.7 +/- 7.9 days; operation time was 6.8 +/- 1.9 h; and cross-clamping time was 154.4 +/- 42.0 min. There was one intraoperative conversion to Bentall procedure; one re-operation for bleeding; one operative death and one case who developed complications. Mean follow-up was 39.7 +/- 21.7 months (range, 12-108 months; cumulative rate, 1483 patients-months; follow-up rate, 94 %). At 5 and 10 years, overall freedom from valve replacement was 94 % and 87 %; freedom from aortic regurgitation grade II or higher was 94 % and 91 %; and freedom from reoperation was 94 % and 90 % years, respectively. Conclusions: The reimplantation type of valve-sparing procedure appears to be facilitated by the use of the De Paulis valsalva graft with satisfactory perioperative and midterm results.