Long-term results of the David Procedure in patients with acute type A aortic dissection

International Journal of Surgery
Nadejda MonsefiAndreas Zierer

Abstract

The David Procedure may provide an attractive alternative to aortic root replacement in patients with aortic valve insufficiency (AI) even in the emergency setting of an acute type A aortic dissection (AAD). From 1996 to 2011 the David Procedure was performed in 23 patients with AAD in our department. Patients' mean age was 49 ± 15 years and 70% (n = 16) were male. Concomitant hemiarch replacement was performed in 19 patients while the remaining 4 patients underwent full arch replacement. Additional leaflet prolapse was corrected by plication in 5 cases. A modification of the classic David technique was performed by creating a pseudosinus in 6 patients (26%) and a neosinus in 9 patients (39%). Mean follow up was 7.7 ± 3 years. Thirty-day mortality was zero. There were 4 late deaths (17%). One patient suffered a perioperative neurologic event (4%). One further patient suffered a late stroke during follow up (0.6%/pt-yr). Three patients (1.7%/pt-yr) required aortic valve reoperation during follow up: in 2 cases leaflet perforation was observed, and one patient had to undergo valve replacement because of endocarditis with severe AI. There were two cases of bleeding events (1.1%/pt-yr) at follow up. The linearized rate for recurren...Continue Reading

References

Aug 1, 1972·The American Journal of Cardiology·C E AnagnostopoulosC F Kittle
Jul 1, 1968·Thorax·H Bentall, A De Bono
May 30, 1998·The Journal of Thoracic and Cardiovascular Surgery·M H YacoubR Radley-Smith
May 11, 2002·Coronary Artery Disease·Marc R Moon, Thoralf M Sundt
Sep 25, 2007·The Annals of Thoracic Surgery·Christian D EtzRandall B Griepp
Dec 1, 2010·The Journal of Thoracic and Cardiovascular Surgery·Christian D EtzGabriele Di Luozzo
Jan 9, 2014·Interactive Cardiovascular and Thoracic Surgery·Nadejda MonsefiAnton Moritz
May 16, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Malakh ShresthaAxel Haverich
Jan 15, 2015·The Annals of Thoracic Surgery·Bradley G LeshnowerEdward P Chen

❮ Previous
Next ❯

Citations

Sep 14, 2018·Anesthesia and Analgesia·Stephen H GregoryMadhav Swaminathan
Jan 20, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Nadejda MonsefiAnton Moritz

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bladder Carcinoma In Situ

Bladder Carcinoma In Situ is a superficial bladder cancer that occurs on the surface layer of the bladder. Discover the latest research on this precancerous condition in this feed.

Related Papers

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Aleksandra MiskovicAnton Moritz
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Pietro G MalvindiTheodore Velissaris
Journal of the American College of Cardiology
T E DavidTimothy Bradley
Seminars in Thoracic and Cardiovascular Surgery
T E David
© 2021 Meta ULC. All rights reserved