Modified David Operation: A New Simple Method Using a Single Inflow Suture Line
The reimplantation technique for valve sparing aortic root replacement is increasingly used to treat aortic root enlargement. The systematic approach described by El Khoury in 2009 and modified in 2011 using the valsava graft (Gelweave valsalva, Sultzer, Vaskutek, renfrewshire, Scotland) is simple and reproducible. However, in-conduit suturing of the aortic valve annulus and small rim of sinus remnant to the graft sinuses is time consuming and may lead to bleeding, or distorsion of the native valve in the prosthetic root. We describe a simple technique to facilitate the native valve reimplantation. A reproducible, easy to achieve single inflow suture line is used allowing avoiding the continuous suture of the native valve used in all valve sparing surgical techniques.
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