Our outcomes of aortic valve sparing reimplantation (David procedure) in patients with ascending aortic aneurysm and type A aortic dissection

Abstract

Aim: To present our outcomes with David procedure in patients with ascending aortic aneurysms (AAA) and type A aortic dissection (AD).

Methods: Thirty-six patients, aged between 38-75 years, followed-up in the cardiovascular surgery clinic of our hospital were included in the study. Patients’ demographic data such as age and gender, type of dissection, urea and creatinine values, length of stay in the ICU, duration of hospitalization were recorded. Outcomes of postoperative and long-term ecography were analyzed.

Results:  Of the 36 patients included in the study, 26 (72.22%) were male and 10 (22.78%) were female. The mean age of all patients was 60 ± 10 years. Ascending aortic aneurysm (AAA) was found in 20 (55.56%) patients and type A aortic dissection (AD) in 16 (44.44%) patients. In the postoperative echocardiography, 7 (23.33%) patients were normal, while 2 (6.67%) had trace aortic insufficiency, 17 (56.67%) patients had mild aortic insufficiency, 3 (10.00%) patients had moderate aortic insufficiency and 1 (3.33%) severe aortic insufficiency. Echocardiography performed one month after the operation revealed normal pathology in 10 (33.33%) trace aortic sufficiency in 2 (6.67%) patients, mild aortic insufficiency in 17 (56.67%) patients, and moderate aortic insufficiency in 1 (3.33%) patient.

Conclusion:  The results of this study indicate that aortic valve-sparing reimplantation (David) procedure can be safely and effectively performed in patients with ascending aortic aneurysm and type A aortic dissection. It eliminates the need for a mechanical prosthesis and its complications.