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J Thorac Cardiovasc Surg 2007;133:560-562
© 2007 The American Association for Thoracic Surgery

Brief Communication

Six stitches to create a neosinus in David-type aortic root resuspension

^a Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt, Germany
^b Department of Cardiovascular Surgery, Güven Hospital, Ankara, Turkey.

Received for publication August 31, 2006; accepted for publication September 13, 2006.

^_* Address for reprints: Tayfun Aybek, MD, Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590 Frankfurt/M, Germany. (Email: Tayfun@Aybek.de).

The first 20% of the full text of this article appears below.

In the past decade, aortic valve–sparing procedures for aortic root dilatation have gained popularity among surgeons.¹ The David technique, originally described as reimplantation of the aortic valve in a cylindric tube graft (David I), has been shown to be associated with certain drawbacks, particularly increased leaflet stress during opening and closing² and possible abrasion of the leaflets as they touch the prosthetic wall. Furthermore, the lack of sinuses may affect the coronary flow.³ Since 1992, this technique has undergone several modifications and refinements⁴ to avoid these imperfections.

Various attempts to restore the sinuses of Valsalva during the valve-sparing procedure have been reported.^2,4,5 A specially designed prosthesis with a bulge at the base is now available (Sulzer Vascutek, Renfrewshire, United Kingdom). These modifications, however, do not create tear-shaped, natural sinuses for a trilobed aortic root but rather result in an ectatic and evenly spherical bulge that accommodates the natural valve. We present a simple and reliable modification to create trilobed neosinuses in a Dacron polyester fabric tube graft to more closely resemble the natural aortic root.

Technique

The base of the aortic . . . [Full Text of this Article]

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