DAVID-V AORTIC VALVE SPARING PROCEDURE: MID-TERM RESULTS
OZGE ALTAS, TANIL OZER, DENIZ GUNAY, EMRE SELCUK, AHMET ELIBOL, SABIT SARIKAYA, YUCEL OZEN, KAAN KIRALI.
KOSUYOLU HEART TRAINING & RESEARCH HOSPITAL, ISTANBUL, Turkey.
OBJECTİVE: Aortic valve-sparing David procedure has gained broad acceptance by avoiding prosthetic valve replacement. One of these procedures, David V, is thought to imitate the natural anatomy of aortic root the most similarly. The early and mid-term results of our clinic are satisfactory; however mid-term results are uncertain.
METHODS: Between April 2009 and December 2015, David-V operation was performed in 43 patients with the mean age of 57.6±13.3 (24-79) years, whereas 30 patients (69.8%) were male. Mean pathology was aneurysm in 33 patients, acute aortic dissection in 5 patients, and bicuspid aortic valve in 5 patients. Fifteen patients received additional procedures. Mean follow-up was 37.4±23.1 months.
RESULTS: Hospital mortality rate was 6.9% (2 low cardiac output syndrome, 1 sepsis). Late mortality was 7.5% with 3 deaths. Reoperation rate was 2.5% with one patient who was re-operated during the early postoperative period because of severe aortic regurgitation. One patient is followed with moderate (> 2) aortic regurgitation, and the others had < mild aortic regurgitation. Thirteen patients (81.1%) were in NYHA functional-class I, and 7 patients (18.9%) in NYHA II. Early transient cerebrovascular event was observed in one patient. There was no rhythm problem.
CONCLUSİONS: Aortic valve sparing procedure provides excellent mid-term effectiveness with very low risk of late events. Mid-term durability of the aortic valve is satisfactory and encourages us to prefer this approach.
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