Procedure

Valve-sparing aortic root replacement: the inclusion (David) technique

Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany

^* Corresponding author: ^* Department of Cardiac Surgery, University Hospital Heidelberg, INF 110, 69120 Heidelberg, Germany Tel.: +49-6221-5637982; fax: +49-6221-565585. Klaus.kallenbach{at}med.uni-heidelberg.de

Presentation of the aortic valve reimplantation technique (David I): Removal of the diseased ascending aorta, excision of the coronary ostia and resection of aortic sinuses up to a rim of 2–3 mm of aortic wall as well as extensive external dissection and mobilization of the aortic root; placement of horizontal sutures placed circumferentially through the annulus underneath the valve; anchoring a Dacron-graft in the aortic root with the sutures; fixation of commissures high into the tube graft; reimplantation of the sinuses into the graft with a blood-tight running suture line; reimplantation of coronary buttons; establishment of distal aortic anastomosis.

Key Words: Aorta • Aortic aneurysm • Surgery • Valves • Valve reconstruction