Expanding the indications for the David V aortic root replacement: Early results

Abstract

In selected patients possessing appropriate aortic cusp anatomy, the David V can be safely and effectively performed for the expanded indications of aortic dissection, severe AI, and reoperative cardiac surgery with low operative risk. Valve function has remained excellent in the short term, providing evidence of durability and a low rate of valve-related complications.

The David V Valve-Sparing Root Replacement Provides Improved Survival Compared With Mechanical Valve-conduits in the Treatment of Young Patients With Aortic Root Pathology

“…In our own institutional experience, it has been previously reported that VSRR operations could be performed with acceptable operative mortality in clinical scenarios that have been typically associated with higher operative risk, including significant aortic insufficiency, reoperative cardiac surgery, and acute type A dissection [11,12]. When applied using appropriate anatomic criteria, valve durability and freedom from moderate aortic insufficiency have been acceptable at midterm follow-up, exceeding 90% [11,12].…”

“…The Emory technique of the David V VSRR and arch replacement has been described previously [11,12]. Patients undergoing isolated aortic root replacement received central aortic and right atrial cannulation.…”

“…Once the decision was made to proceed with VSRR, reimplantation with David V method was performed, as previously described [11,12]. The majority of graft prostheses were tailored straight tube grafts; however, the Gelweave Valsalva (Vascutek; Terumo, Ann Arbor, MI) and the Cardioroot (Maquet, Wayne, NJ) grafts were occasionally used.…”

“…When applied using appropriate anatomic criteria, valve durability and freedom from moderate aortic insufficiency have been acceptable at midterm follow-up, exceeding 90% [11,12].…”

Midterm Results of David V Valve-Sparing Aortic Root Replacement in Acute Type A Aortic Dissection

“…The Emory technique of the David V and aortic arch replacement has been described previously [11,12]. Transcutaneous cerebral oximetry (INVOS 3100-SD, Troy MI) and continuous electroencephalographic monitoring were performed on every patient.…”