The David Procedure in Different Valve Pathologies: A Single-Center Experience in 236 Patients

Liebrich, M.; Kruszynski, M; Roser, Detlev; Meisner, Christoph; Hemmer, Wolfgang; Weimar, Timo

doi:10.1016/j.athoracsur.2012.08.010

Cited by 37 publications

(28 citation statements)

References 27 publications

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“…The valve was then reimplanted into the prosthesis using a continuous suture line following the scalloped shape of the free margin of the native valve, allowing for correct cusp geometry and sufficient height of commissural resuspension within the prosthesis. The coronary ostia were implanted into the graft with a running suture [21]. The size of the vascular graft used for reimplantation of the aortic valve was 29.5 AE 1.7 mm.…”

Section: Reoperative Surgical Techniquementioning

confidence: 99%

“…However, we have previously reported excellent survival and low reoperation rates when using a reinforced full root technique [13]. The mechanisms involved in a failing pulmonary autograft are by nature similar to those observed in the native aortic valve with dilatation of the aortic root [21]. Reoperations on the aortic root are technically challenging and carry increased operative risk [22].…”

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confidence: 96%

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The David Procedure for Salvage of a Failing Autograft After the Ross Operation

Liebrich¹,

Weimar²,

Tzanavaros³

et al. 2014

The Annals of Thoracic Surgery

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Section: Reoperative Surgical Techniquementioning

confidence: 99%

mentioning

confidence: 96%

The David Procedure for Salvage of a Failing Autograft After the Ross Operation

Liebrich¹,

Weimar²,

Tzanavaros³

et al. 2014

The Annals of Thoracic Surgery

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“…The rate of freedom from valve replacement was 94 and 87% at 5 and 10 years, respectively. Twenty-six patients had MFS and the rates of freedom from valve replacement and from AR >2+ were 100% [22]. Hanke et al from Sievers' group reported on 191 V-SARR procedures including David II remodelling and David I procedures, with 13 and 20% of patients having MFS [23].…”

Section: Results Of David I Type Of Valve-sparing Aortic Root Replacementioning

confidence: 99%

“…Liebrich et al [22] recently reported their experience with 236 David I procedures; mean age was 56 years with a cumulative follow-up of 896 patient-years. The rate of freedom from valve replacement was 94 and 87% at 5 and 10 years, respectively.…”

Section: Results Of David I Type Of Valve-sparing Aortic Root Replacementioning

confidence: 99%

David I reimplantation procedure for aortic root replacement in Marfan patients: medium-term outcome

Kari

Beyersdorf

Rylski

et al. 2014

Interact CardioVasc Thorac Surg

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OBJECTIVES: Technical variations of the David reimplantation valve-sparing aortic root replacement (V-SARR) procedure have been proposed to be advantageous in patients with connective tissue disease, such as the Marfan syndrome (MFS). We report results of a Marfan cohort treated exclusively with the non-modified David I procedure.METHODS: Forty-eight Marfan patients (25 males, mean age 33 ± 12 years, range 15-62 years) underwent the original variant of the David V-SARR (David I) between 1997 and 2013. Forty-two operations (88%) were performed as elective procedures for aortic root aneurysms and six for acute dissections (12%). Seventeen had aortic regurgitation (AR) grades ≥2+ preoperatively, and 3 had AR >2+. No patients with severe AR (4+) were selected for V-SARR. Three full or hemi-arch replacements were performed. Patients who were operated on using a variation of the David I or David II procedure were excluded. RESULTS:Mean prosthesis size was 28 ± 3 mm (18-30 mm). Mean clinical and echocardiographic follow-up (98% complete) was 3.8 ± 3.7 years with a cumulative follow-up of 178 patient-years. The early mortality rate was 2% (one hospital death). The survival rate was 98% (95% confidence 84-99%) at 4 years and 90% (57-98%) at 8 years with 5 patients at risk at 10 years. The rate of freedom from root or valve reoperation was 97% (79-99%) and 97% (79-99%) at 4 and 8 years, respectively. Only one patient required mechanical aortic valve replacement for progression of AR. CONCLUSIONS:Despite potential theoretical drawbacks of the David I V-SARR technique without neo-sinuses or a neo-sinotubular junction, it results in a favourable mid-term outcome in Marfan patients and compares well with reported results of different modifications of David V-SARR.

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“…Eще в одном исследовании [15] сравнили ближайшие и отдаленные результаты операций Дэвида у 201 пациента с ТАК и 35 с ДАК. Средний период наблюдения составил 4,5±2,7 года (от 0,6 до 13,7 года).…”

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