Valve-sparing aortic root replacement

Valve-sparing aortic root replacement (also known as David procedure) is a cardiac surgery technique that preserves the patient's own aortic valve when the aortic root is diseased or aneurysmal. This procedure is an alternative to traditional aortic root replacement methods, which often involve replacing the aortic valve with a mechanical or biological prosthesis.

Indications

Valve-sparing aortic root replacement is indicated for patients with an aortic aneurysm or aortic dissection who have a normally functioning aortic valve. It is also used in patients with Marfan syndrome, Ehlers-Danlos syndrome, and other connective tissue disorders that predispose to aortic root dilation and dissection.

Procedure

The procedure involves removing the diseased portion of the aortic root while leaving the aortic valve intact. The aortic root is then replaced with a Dacron graft, which is sewn to the remaining portion of the aorta and the aortic valve. The coronary arteries, which originate from the aortic root, are also re-implanted into the Dacron graft.

Advantages

The main advantage of valve-sparing aortic root replacement is that it allows patients to keep their own aortic valve, avoiding the need for anticoagulation therapy that is required with mechanical valve replacements. This can significantly improve the patient's quality of life and reduce the risk of thromboembolism and bleeding complications.

Risks and Complications

As with any major surgery, valve-sparing aortic root replacement carries risks, including bleeding, infection, stroke, and heart attack. There is also a risk of aortic insufficiency if the aortic valve is not properly preserved during the procedure.

See Also

• Aortic valve repair
• Aortic dissection
• Marfan syndrome
• Ehlers-Danlos syndrome