Valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of pregnancy

Abstract

The article presents a clinical case of valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of gestation followed by successful prolongation of pregnancy. Indications for reconstructive intervention with cardiopulmonary bypass were: severe aortic valve insufficiency, Sinus of Valsalva Aneurysm (66 mm) and the ascending aorta dilatation (53 mm) with a rapid increase of aortic root dimension (12 mm during 9 weeks). The patient underwent a valve sparing aortic root replacement according to David procedure using Gelweave Valsalva graft (Vascutec) No 28 The time of cardiopulmonary bypass was 137 minutes; the time of aortic cross-clamping was 107 minutes. The patient was discharged from the hospital in a satisfactory condition in 21 days after the operation. Pregnancy was prolonged and ended with a planned cesarean section at 38 weeks of gestation, the birth of a boy with an Apgar score of 7/8.

Aortic regurgitation in Marfan syndrome patients who underwent prophylactic surgery: A single-center experience

“…Previous studies have confirmed the safety and efficacy of valve-sparing operations in selected patients. 3,[19][20][21] A recently published systemic review emphasized the advantages of the valve-sparing procedure in MFS patients. Its long-and short-term results included lower in-hospital, longterm mortality, and lower valve-related reintervention rates.…”